关键词： 新型冠状病毒感染   医护人员   物表核酸   负压隔离病房   定点医院  

摘要： 目的评估医护人员感染新型冠状病毒的风险性,为新冠肺炎三级定点医院感染防控提供科学依据。方法于2022年11—12月,对在某新冠肺炎三级定点医院负压隔离病房工作的8名医护人员出隔离病区后的物表[外穿防护用品(防护服、N95口罩、防护面屏、外科手套、靴套)和内穿洗手衣、手术鞋]及体表(手、脸、脖颈、头发、胳膊)采样,所有标本均采用RT-PCR方法进行新型冠状病毒检测,采用SPSS 26.0软件进行统计学分析。结果共采集标本1792份,其中物表阳性标本共计308份,占物表标本总数的19.64%;体表阳性标本8份,占体表标本总数的3.57%。7个物表采集部位核酸结果均有阳性出现,其中靴套阳性率最高,占66.10%,其次是外科手套,占28.57%,内穿手术鞋阳性率位居第三,占16.96%。物表标本中,35≤CT值≤40的标本270份,占物表总数的17.22%;CT值<35的标本38份,占2.42%。体表阳性标本8份,35≤CT值≤40。结论负压隔离病房医护人员的靴套和外科手套检出阳性率位居前两位,其次内穿手术鞋物表和体表也均有阳性出现,提示医护在进行一脱区脱摘防护用品时有一定的感染风险,应对一脱区加强环境消毒和空气净化以减少医护感染概率,保证定点医院工作的正常进行。

关键词： 新型冠状病毒感染   病毒性肺炎方   中医药疗法  

摘要： 目的:观察病毒性肺炎方治疗新型冠状病毒感染的临床效果。方法:将65例确诊新型冠状病毒奥密克戎毒株感染患者分为病毒性肺炎方治疗组和中医辨证治疗组,其中病毒性肺炎方治疗组34例,中医辨证治疗组31例。中医辨证治疗组参照《新型冠状病毒肺炎诊疗方案(试行第九版)》推荐中药处方分为湿郁肺脾型、湿热蕴毒型、肺脾气虚型3型辨证治疗。治疗中观察两组患者主要症状发热、咳嗽咳痰、咽痛、鼻塞流涕消失时间及鼻咽、口咽拭子新型冠状病毒核酸N基因及OFR基因(连续两次,采样间隔24小时)CT值≥35时间。结果:病毒性肺炎方治疗组在退热,缓解咽痛、鼻塞流涕时间方面与中医辨证治疗组相当,两组比较,差异无统计学意义(P>0.05)。在缓解咳嗽咳痰时间方面,病毒性肺炎方治疗组为(3.7±1.8)天,中医辨证治疗组为(5.2±1.9)天,两组比较P<0.05,t=2.45;病毒核酸N基因及OFR基因CT值≥35时间方面,病毒性肺炎方治疗组为(15.0±5.4)天,中医辨证治疗组为(18.8±7.7)天,两组比较P<0.05,t=2.32,病毒性肺炎方治疗组稍优于中医辨证治疗组,两组差异有统计学意义。结论:病毒性肺炎方治疗新型冠状病毒奥密克戎毒株感染在退热,缓解咽痛、鼻塞流涕方面与辨证治疗相当,缓解咳嗽咳痰及核酸转阴时间方面较辨证治疗有一定优势,具有一定的临床推广价值。

关键词： 老年人   新型冠状病毒感染   中医诊疗   专家共识  

摘要： 临床发现年龄大于65岁、未全程接种新型冠状病毒疫苗、合并慢性疾病者,是新型冠状病毒感染后重型/危重型的高危人群,也是医疗救治的重点。本文通过解读《北京市老年新型冠状病毒感染病症结合中医诊疗专家共识》,利于其临床推广应用。重点解读老年新型冠状病毒感染的中医救治基本策略,强调老年人多正气虚损,治疗原则是顾护正气,扶正祛邪。并针对临床中常见病症如热盛不退、大便难、痰液排出不畅、肺部影像学炎症渗出加重、合并慢性基础疾病等进行重点分析。凝练老年新型冠状病毒感染的临床辨治要点,提出临床应重视肺肠同治,重视排痰,重视脾胃功能,积极治疗基础疾病,危重症以保肺之化源为要,重视中成药注射剂和针灸治疗等,以提高老年新型冠状病毒感染救治疗效,降低死亡率。

关键词： 新冠肺炎   医学图像处理   语义分割   多尺度特征提取  

摘要： 目的改进U-Net图像分割算法,探讨多尺度特征提取对新冠肺炎CT图像分割应用的价值。方法利用Python编程语言和tensorflow和keras深度学习框架,在U-Net基线网络结构基础上,结合空洞空间卷积池化金字塔和高效通道注意力机制设计多尺度特征选择模块,提出改进后的多尺度特征选择网络(MsFS-Net),在COVID-19-20公开数据集上进行实验验证,使用5折交叉验证方法,对比U-Net、DeepLabV3+和Attention U-Net 3个网络模型,评测指标包括Dice、Recall、Precision,并绘制训练曲线图和可视化分割结果图。结果计算Dice、Recall、Precision 3项评测指标在5折交叉验证中的平均值和标准差,MsFS-Net的指标分别为(85.05±0.25)%,(85.33±0.20)%,(85.10±0.30)%,相比U-Net网络提升效果显著,平均值分别提升5.89%、5.71%、5.30%,标准差更小,训练曲线平滑稳定,对小病灶和不规则病灶的分割效果优于其他模型,模型鲁棒性更好。结论基于多尺度特征选择的图像分割方法具有高性能、高准确率的特点,在新冠肺炎图像自动分割中具有应用价值。

关键词： phase-1   intranasal   DelNS1-nCoV-RBD LAIV   COVID-19  

摘要： An intranasal COVID-19 vaccine, DelNS1-based RBD vaccines composed of H1N1 subtype (DelNS1-nCoV-RBD LAIV) was developed to evaluate the safety and immunogenicity in healthy adults. We conducted a phase 1 randomized, double-blinded, placebo-controlled study on healthy participants, age 18-55 and COVID-19 vaccines naive, between March and September 2021. Participants were enrolled and randomly assigned (2:2:1) into the low and high dose DelNS1-nCoV-RBD LAIV manufactured in chicken embryonated eggs or placebo groups. The low and high-dose vaccine were composed of 1 x 10(7) EID50/ dose and 1 x 10(7.7) EID50/ dose in 0.2 mL respectively. The placebo vaccine was composed of inert excipients/dose in 0.2 mL. Recruited participants were administered the vaccine intranasally on day 0 and day 28. The primary end-point was the safety of the vaccine. The secondary endpoints included cellular, humoral, and mucosal immune responses post-vaccination at pre-specified time-points. The cellular response was measured by the T-cell ELISpot assay. The humoral response was measured by the serum anti-RBD IgG and live-virus neutralizing antibody against SARS-CoV-2. The saliva total Ig antibody responses in mucosal secretion against SARS-CoV-2 RBD was also assessed. Twenty-nine healthy Chinese participants were vaccinated (low-dose: 11;high-dose: 12 and placebo: 6). The median age was 26 years. Twenty participants (69%) were male. No participant was discontinued due to an adverse event or COVID-19 infection during the clinical trial. There was no significant difference in the incidence of adverse events (p = 0.620). For the T-cell response elicited after full vaccination, the positive PBMC in the high-dose group increased to 12.5 SFU/10(6) PMBC (day 42) from 0 (baseline), while it increased to 5 SFU/10(6) PBMC (day 42) from 2.5 SFU/10(6) PBMC (baseline) in the placebo group. The high-dose group showed a slightly higher level of mucosal Ig than the control group after receiving two doses of t

摘要： Dear Editor, we would like to share ideas on the publication “Vaccine associated benign headache and cutaneous hemorrhage after ChAdOx1 nCoV-19 vaccine: A cohort study .” If these symptoms are a minor form of VITT, with a possibility for worsening...

关键词： 新型冠状病毒肺炎   用药法   手册  

ISBN: (纸本)9787117347181

摘要： 新型冠状病毒流行3年来，其药物治疗随着医药学研究的进展和人们认识的深入在不断变化。药物是新冠病毒感染治疗的主要手段，本书按照药物的功能进行分类，分为抗病毒药、抗炎抗凝药、解热镇痛药、缓解上呼吸道局部症状的药，以及对症治疗的中成药。在内容上，详细介绍每个药物的药理作用、作用机制、功能主治、临床应用，重点介绍药物的不良反应，同时突出用法用量和注意事项，为临床医务人员提供规范化、专业化的指导，以缓解就医压力，促进机体康复。

关键词： ChAdOx1 nCoV-19   adenovirus vaccines   adenoviridae   immunogenicity   vaccine  

摘要： This study investigated the immunogenicity of, and reactogenicity to, the ChAdOx1 nCoV-19 vaccine according to pre-existing adenovirus immunity. Individuals scheduled for COVID-19 vaccination were prospectively enrolled in a tertiary hospital with 2400 beds from March 2020 onwards. Pre-existing adenovirus immunity data was obtained before ChAdOx1 nCoV-19 vaccination. A total of 68 adult patients administered two doses of the ChAdOx1 nCoV-19 vaccine were enrolled. Pre-existing adenovirus immunity was identified in 49 patients (72.1%), but not in the remaining 19 patients (27.9%). The geometric mean titer of S-specific IgG antibodies was statistically higher in individuals without pre-existing adenovirus immunity at several time points: before the second ChAdOx1 nCoV-19 dose (56.4 (36.6-125.0) vs. 51.0 (17.9-122.3), p = 0.024), 2-3 weeks after the second ChAdOx1 nCoV-19 dose (629.5 (451.5-926.5) vs. 555.0 (287.3-926.0), p = 0.049), and 3 months after the second ChAdOx1 nCoV-19 dose (274.5 (160.5-655.3) vs. 176.0 (94.3-255.3), p = 0.033). In the absence of pre-existing adenovirus immunity, systemic events were observed with higher frequency, especially chills (73.7% vs. 31.9%, p = 0.002). In conclusion, individuals without pre-existing adenovirus immunity showed a higher immune response to ChAdOx1 nCoV-19 vaccination and a higher frequency of reactogenicity to ChAdOx1 nCoV-19 vaccination was observed.

关键词： COVID19   Severe acute respiratory syndrome-coronavirus (SARS-CoV-2)   Human receptor angiotensin converting enzyme-2 (hACE2)   Receptor binding domain (RBD)   Monoclonal antibody   Spike (S) protein   Cellular immune responses  

摘要： SARS, or severe acute respiratory syndrome, is caused by a novel coronavirus (COVID-19). This situation has compelled many pharmaceutical R&D companies and public health research sectors to focus their efforts on developing effective therapeutics. SARS-nCoV-2 was chosen as a protein spike to targeted monoclonal antibodies and therapeutics for prevention and treatment. Deep mutational scanning created a monoclonal antibody to characterize the effects of mutations in a variable antibody fragment based on its expression levels, specificity, stability, and affinity for specific antigenic conserved epitopes to the Spike-S-Receptor Binding Domain (RBD). Improved contacts between Fv light and heavy chains and the targeted antigens of RBD could result in a highly potent neutralizing antibody (NAbs) response as well as cross-protection against other SARS-nCoV-2 strains. It undergoes multipoint core mutations that combine enhancing mutations, resulting in increased binding affinity and significantly increased stability between RBD and antibody. In addition, we improved. Structures of variable fragment (Fv) complexed with the RBD of Spike protein were subjected to our established in-silico antibody-engineering platform to obtain enhanced binding affinity to SARS-nCoV-2 and develop ability profiling. We found that the size and three-dimensional shape of epitopes significantly impacted the activity of antibodies produced against the RBD of Spike protein. Overall, because of the conformational changes between RBD and hACE2, it prevents viral entry. As a result of this in-silico study, the designed antibody can be used as a promising therapeutic strategy to treat COVID-19. [GRAPHICS] .