According to the requirements for the “three districts and two channels” in the sanitary industry standard Technique Standard for Isolation in Hospitals, combining with the spirit of current documents related to the prevention and control of coronavirus disease 2019, in order to guide medical institutions at all levels to conduct standardized design of fever clinics in accordance with the principle of “combining normal time and epidemic period”, this article explains the design points of the fever clinics for the prevention and control of coronavirus disease 2019, introduces the specific methods for the fever clinics to achieve “three districts and two channels”, draws a schematic diagram of the fever clinics in general hospitals, and explains the functional layout and medical procedures of the clean area, potential contaminated area, and contaminated area in detail; at the same time, a schematic diagram of the change of fever clinics from “normal” to “during the epidemic” is drawn, and the ideas for the conversion and the process after the conversion are introduced. It proposes design ideas and drawing references for the construction, transformation, and expansion of fever clinics.
ObjectiveTo systematically review the clinical efficacy and safety of glucocorticoids, acetaminophen and antimicrobial drugs in the treatment of intrapartum fever in labor analgesia. MethodsThe PubMed, Embase, Cochrane Library, Web of Science, CBM, VIP, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of glucocorticoids, acetaminophen, and antimicrobial drugs for intrapartum fever in labor analgesia from inception to June 30, 2023. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included literature. Meta-analysis was then performed by using RevMan 5.4 software. ResultsA total of 10 RCTs involving 1 337 women were included. Meta-analysis showed that the use of glucocorticoids reduced the incidence of intrapartum fever in women with labor analgesia compared with the control group (OR=0.52, 95%CI 0.33 to 0.82, P<0.01). But there was no statistically significant difference between acetaminophen or antimicrobial drugs and the control group. ConclusionCurrent evidence shows that the use of glucocorticoids can reduce the incidence of intrapartum fever in labor analgesia, but the use of acetaminophen and antimicrobial drugs cannot reduce the incidence of intrapartum fever. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To analyze the clinical characteristics and risk factors of noninfectious fever after endovascular repair of aortic dilatation diseases, and explore the management strategy. Methods We reviewed 468 patients who received endovascular aortic repair from January 2021 to October 2023. The patients who were selected were classified into a febrile group and an afebrile group according the fever after operation. The fever data were analyzed, and the demographics, operative data were researched to sieve out the correlation factors. Logistic regression analysis was conducted for the risk factors of postoperative fever if the P value≤0.05 in the univariate analysis, and receiver operating characteristic curve (ROC) was used to analyze the predictive indexes of postoperative noninfectious fever. Results75.08% (229/305) patients had noninfectious fever after aortic repair and 98.25% of them had fever within 2 days. There were 229 patients in the febrile group, mean age 65 (53.0,73.0) years (83.4% males , and 76 patients in the afebrile group, mean age 71(65.0,76.7) years(84.2% males). Univariate analysis showed that the number of patients with coronary heart disease, using statins before operation and aortic aneurysm in the febrile group were significantly lower than those in the afebrile group, and patients were younger in the febrile group. The logistic regression showed that age, surgical site, type of disease, preoperative hyperthermia, type of stent were positively correlated with noninfectious fever, while statin use was negatively associated with noninfectious fever. And age, surgical site, preoperative hyperthermia and stent type were analyzed by means of ROC curve (P<0.01). Conclusion Noninfectious fever is very common after aortic repair. The relationship between fever and infection should be comprehensively judged according to the risk factors of noninfectious fever and the disease status to promote rational use of antibiotics.
目的:分析输血反应类型,分布及概率。方法:回顾性分析我院2008年11月至2009年4月各类输血事件,收集输血不良反应回报单,进行统计分析。结果:在共计8996人次输血中,发生输血不良反应47人次,其中输注血浆引起的输血不良反应率为0.68％,输注红细胞悬液的不良反应率为0.30％,总的输血不良反应率0.98％,不同血液制品输血不良反应发生率具显著性差异(Plt;0.05)。其中主要表现为过敏反应,占63％,其次为发热反应.结论:如何提高临床科室科学合理用血水平的方法需进一步探讨。
Objective To explore the effect of epidural analgesia for labor on maternal temperature and the newborns. Methods This randomized trial was performed in West China Second Hospital between December 2015 and July 2016. Fifty puerperants were randomly divided into epidural analgesia (EA) group (natural labor under EA, n=25) or the control group (natural labor using Ramaze breathing method, n=25). Maternal tympanic temperature was recorded once per hour after treating with painless labor or blank control. The serum interleukin-1 beta (IL-1β) and heat shock protein 70 (HSP70) level were measured from the blood of the umbilical cord after the delivery. Apgar scores of the newborns were also recorded. Results There was a significant difference in the temperature between EA and control group one hour after the treatment of painless labor [ (36.9±0.7) and (36.4±0.5)℃]. The level of serum IL-1β and HSP70 were significantly higher in EA group [IL-1β: (0.308±0.036) ng/mL; HSP70: 1.175±0.196] than those in the control group [IL-1β: (0.244±0.031) ng/mL; HSP70: 0.935±0.308] (P<0.05). However, no significant difference was found in the neonatal Apgar score (P>0.05). Conclusions The increase of maternal temperature is greater in the EA labor puerperants compared with that in the controls, which may be related to the increase of IL-1β and HSP70. No adverse effect of labor analgesia on new borns is found
Abstract: Objective To determine the incidence, course, potential risk factors and outcomes of postoperative noninfectious fever in aortic surgical patients. Methods We reviewed 549 patients who received operation for aortic aneurysm or dissection in Beijing FuWai Cardiovascular Disease Hospital from January 2006 to January 2008. After excluding patients with a known source of infection during hospitalization, patients who had preoperative oral temperature greater than or equal to 38.0℃, patients who underwent emergency surgery, patients who died of other reasons other than feverrelated factors, and patients with incomplete data, we finally enrolled a total of 463 patients for final analysis. Depending on whether the patients developed a noninfectious fever after operation, we classified them into the febrile group (n=345, highest oral temperature ranging from 38.0-39.3℃) and the afebrile group (n=118, without postoperative fever). Univariate analysis was performed between these two groups of patients, with respect to demographics, operative data and postoperative conditions. Risk factors for postoperative fever were considered for the multivariate logistic regression model if they had a P value≤0.001 in the univariate analysis. Results After operation, 74.5%(345/463) of the patients had noninfectious fever. The minimum temperature of febrile patients on the operation day and the first postoperative day were both higher than afebrile patients（P=0.000，0.000）. The maximum temperature of febrile patients on the operation day, the first, second，third and fourth postoperative days were also higher than afebrile patients（P=0.000，0.000, 0.047, 0.018）. Univariate analysis demonstrated that weight (P=0.000), surgical type (P=0.000), minimum intraoperative bladder temperature (P=0.000), temperature upon ICU admission (P=0.000) and blood transfusion (P=0.000) were all risk factors for noninfectious postoperative fever. The multivariate logistic regression showed that surgical sites of thoracic and thoracoabdominal aorta (odds ratio: 4861; 95% confidence interval: 3.029，5.801; P=0.004), lower minimum intraoperative bladder temperature (odds ratio: 1.117; 95% confidence interval:1.013，1.244;P=0.040) and higher temperature on admission to the ICU (odds ratio: 2.570; 95% confidence interval:1.280，5.182;P=0.008) were significant predictors for postoperative noninfectious fever. Conclusion Noninfectious postoperative fever following aortic surgery is very common. Predictors of noninfectious postoperative fever following aortic surgery include surgical sites (thoracic or thoracoabdominal aorta), low intraoperative core temperature and temperature elevation in the immediate postoperative period.
ObjectiveTo discuss clinical manifestation, laboratory examination, imaging and pathological features of intrahepatic cholangiocellular carcinoma(ICC) patients with fever as initial symptom accompanied with liver area pain, in order to improve the clinicians' acquaintance for ICC under similar circumstances. MethodThe case informations including medical history, clinical manifestation, laboratory examination, imaging finding, pathological examination, and treatment of 4 patients diagnosed with ICC by pathological biopsy from july 2013 to October 2014 in the First hospital of Lanzhou University were analyzed retrospectively. ResultsAll of four cases showed the fever as the initial symptom accompanied with the liver area pain. All of them had got chronic HBV infection. The WBC, neutrophil percentage, and procalcitonin were increased on admission in 3 cases. the levels of serum ALP and GGT were elevated in 3 patients. The AFP was obviously increased in 1 patient. The serum CA19-9 had moderately elevated in 2 patients. the ferroprotein was obviously increased in 2 patients. All the patients were confirmed under the abdominal CT scans and the liver pathological biopsy. ConclusionPatients with fever and liver area pain as intial symptoms, and with chronic hepatitis B and space-occupying lesions, who should be alert for ICC.
During the prevention and control of coronavirus disease 2019, West China Hospital of Sichuan University urgently set up 4 medical tents to conduct centralized screening of fever patients, effectively avoiding cross-infection, and at the same time alleviating the pressure on the Department of Emergency Medicine and improving the efficiency of medical treatment for patients with fever. Later, in order to actively respond to China’s severe acute respiratory syndrome coronavirus 2 nucleic acid detection policy, 5 tents were adjusted to carry out the severe acute respiratory syndrome coronavirus 2 nucleic acid detection. This article introduces the function setting, personnel arrangement and protective measures of medical tents in West China Hospital of Sichuan University during the prevention and control of coronavirus disease 2019. It aims to share the experience of urgently setting up medical tents in the prevention and control of coronavirus disease 2019, with a view to provide a reference for the construction of medical tents in other medical institutions.