目的 探索老龄化形势下广州市白云区西部卒中防治工作的新模式。方法 通过完善组织结构、管理架构、建立稳定高效运行的(1+1+N)紧密型医联体模式,创建优质高效的卒中救治区域联盟,实现高质量的基层首诊,双向转诊,快速响应的卒中绿道急救和全程管理。结果 初步完成构建广州市白云区西部区域性卒中救治中心,区域内卒中患者及时救治,溶栓效率,血管再通等均有显著提升,整体提升白云区西部医疗机构的卒中救治水平。结论 区域性的协同救治是提高卒中救治水平的重要举措。(1+1+N)紧密型医联体模式能提高卒中患者救治率,具有可行性和必要性。

Objective To explore the effectiveness of a new stroke prevention and treatment pattern in the western part of Baiyun District, Guangzhou city, under an aging situation. Method We aim to build a high-quality and efficient stroke treatment regional alliance based on a (1+1+N) compact medical consortium, expecting to improve the overall abilities of stroke treatment in the western part of Baiyun District through high-quality primary care, two-way referrals, rapid response to stroke greenway emergency and full-process management. Results We have initially established a regional stroke treatment center in the western part of Baiyun District, Guangzhou. Stroke patients in that region can be treated in time, and the efficiency of thrombolysis and vascular recanalization have been significantly improved. Conclusion Regional coordinated treatment is an effective measure to reduce the disability and fatality rate of stroke. The (1+1+N) compact medical consortium model can improve the treatment effect in stroke patients, which is feasible and necessary.

目的 研究煤工尘肺(coal worker's pneumoconiosis, CWP)患者电子计算机断层扫描(computed tomograghy, CT)的影像学表现。方法 选取2017年10月—2020年10月我院CWP患者102例,均行CT检查、X线胸片检查,比较CT检查、X线胸片检查影像学征象、小阴影形态、大阴影影像学表现,并对比CT检查、X线胸片检查并发症情况(灶周气肿、胸膜改变、淋巴结肿大、钙化)。结果 CT检查、X线胸片检查大阴影、肺内钙化影、肺大疱、空洞检出率比较,差异无统计学意义(P＞0.05);CT检查小阴影检出率82.03%高于X线胸片检查73.20%(P＜0.05);CWP患者小阴影主要形态为q/q,且CT检查q/q比例82.67%高于X线胸片检查72.77%(P＜0.05);CT检查灶周气肿31.37%、胸膜改变21.57%、淋巴结肿大15.69%、钙化18.63%, 高于X线胸片检查18.63%、10.78%、6.86%、8.82%(P＜0.05)。结论 CT检查CWP患者影像学征象、并发症检出率均高于X线胸片检查,且小阴影以q/q为主,对大阴影表现明显,有助于病情早期诊断及治疗方案的制定。

Objective To study the imaging features of computed tomograghy (CT) scanning in coal worker's pneumoconiosis (CWP). Methods A total of 102 CWP patients in our hospital from October 2017 to October 2020 were selected. CT examination and X-ray chest examination were performed to compare the imaging features, small shadow shape and large shadow imaging manifestations, and compared the complications of CT examination and X-ray chest examination (focal emphysema, pleura change, lymph node enlargement and calcification). Results There was no statistical difference in the detection rates of large shadow, calcification shadow, pulmonary bulla and cavity in CT and X-ray chest examination (P>0.05); the detection rate of small shadow in CT was 82.03%, which was higher than that of X-ray chest examination (73.20%, P<0.05); the main shape of small shadow in CWP patients was q/q, and the q/q ratio of CT examination was 82.67%, higher than that of X-ray chest examination (72.77%, P<0.05); the detection rates of the focal emphysema by CT examination was 31.37%, the changes of pleura were 21.57%, lymph node enlargement was 15.69%, calcification was 18.63%, which were higher than those of X-ray chest examination (18.63%, 10.78%, 6.86%, 8.82%, P<0.05). Conclusion The detection rate of imaging signs and complications in CWP patients by CT was higher than that of X-ray, and the small shadow was mainly q/q, and CT examination was obvious for detecting large shadow, which was helpful for the early diagnosis and treatment of the disease.

目的 探讨广州地区儿童2019新型冠状病毒(2019 novel coronavirus, 2019-nCoV)感染筛查/疑似病例的流行病学特点、发病特点、可能的原因及防控建议。方法 回顾性分析2020年1月20日—2020年2月29日广州市唯一一家儿童2019-nCoV感染隔离定点医疗单位隔离病房收治住院的符合儿童2019-nCoV感染筛查/疑似病例129例,对其流行病学、发病特点、临床特征、实验室检查及转归、随访等进行总结分析。 结果 男 79例,女 50例,最小1个月,最大13岁,中位数2岁,51例(39.5%)有武汉疫区旅游或居住史,20例(15.5%)有与来自疫区有呼吸道症状人员接触史,17例(13.1%)周边或社区有确诊病例,3例(2.3%)有确诊病人接触史(其中2例为家庭确诊病例密切接触史),38例(29.5%)为临床符合或聚集性发病;临床症状:发热121例(93.8%),咳嗽92例(71.3%),流涕50例(38.8%),32例伴有腹泻、呕吐/腹痛(24.8%),102例(79.0%)白细胞降低或正常,C反应蛋白(C-reactive protein,CRP)＜20 mg/L有103例(79.8%),57例(44.2%)胸片或CT示肺部斑片状影或实变;病原学检查:2019-nCoV实时荧光定量反转录PCR检测结果:所有患儿及陪同家属都有行咽拭子检查,只有21例患儿(16.3%)有行肛拭子检查,仅有1例(0.78%)家庭确诊病例密切接触者肛拭子阳性,但连续多次咽拭子结果阴性,余患者肛拭子和咽拭子及陪同家属咽拭子结果均阴性。其他病原学检查结果61例(47.3%),包括14例RSV阳性,9例流感病毒A,8例人偏肺病毒,6例肠道病毒,6例流感病毒B,6例肺炎支原体,4例副流感病毒1型,1例副流感病毒3型,2例人博卡病毒,3例腺病毒,1例肺炎克雷伯菌,1例人型葡萄球菌,其中1例合并副流感病毒1型及人博卡病毒。跟踪唯一1例确诊患者咽拭子多次检查均阴性,肛拭子持续19天后才转阴,一直无任何症状。其余患者好转出院后第3天、7天及14天进行随访,无异常发现。结论 儿童2019-nCoV感染筛查/疑似病例临床多表现为呼吸道或消化道症状,确诊主要依靠核酸检测,新冠病毒感染确诊率极低,而其将近50%病例能找到除新冠病毒外的其它相关病原体;高危患者为密切接触者,但存在漏诊的可能,肛拭子阳性率或高于咽拭子。

Objective To explore the epidemiological characteristics, onset characteristics, pathogenic mechanism of 2019-nCoV infection in children, and its control and prevention in Guangzhou. Methods From January 20, 2020 to February 29, 2020, a retrospective analysis was carried out on 129 suspected cases of 2019-nCoV infection admitted to the isolation ward of the only medical unit designated for children in Guangzhou. The epidemiology, disease characteristics, clinical characteristics, laboratory examination, outcome and follow-up were summarized and analyzed. Results There were 79 males and 50 females, with a minimum age of 1 month and a maximum age of 13 years. Anong them, 51 cases (39.5%) had a history of tourism or residence in the epidemic area of Wuhan, 20 cases (15.5%) had a history of contact with people with respiratory symptoms from the epidemic area, 17 cases (13.1%) with a confirmed case in the surrounding area or community, 3 cases (2.3%) had a history of contact with a confirmed patient (2 of them were family clustering cases), 38 cases (29.5%) were clinically suspected cases. Clinical symptoms: 121 cases with fever (93.8%), 92 cases with coughing (71.3%), 50 cases with runny nose (38.8%), 32 cases with diarrhea, vomiting or abdominal pain (24.8%). In 102 cases (79.0%), white blood cells were decreased or normal, 103 cases (79.8%) with CRP＜20 mg/L, and 57 cases (44.2%) showed focal infection on chest X-ray or CT scan. Etiological examination: only one case (0.78%) of the family confirmed cases had positive anal swab result, but the throat swab results were negative all the time. The anal swab and throat swab results of other patients and the throat swab results of their accompanying family members were negative. Other pathogens were detected in 61 cases (47.3%), including 14 RSV positive cases, 9 influenza A positive cases, 8 human metapneumovirus positive cases, 6 enterovirus positive cases, 6 influenza B positive cases, 6 Mycoplasma pneumoniae positive cases, 4 parainfluenza virus type 1 positive cases, 1 parainfluenza virus type 3 positive cases, 2 human bocavirus positive cases, 3 adenovirus positive cases, 1 Klebsiella pneumoniae positive cases, 1 Human Staphylococcus positive case, and 1 case with parainfluenza virus type 1 and human bocavirus. The only confirmed patient was followed up while multiple pharyngeal swab results were negative, and the positive anal swab results lasted for 19 days before turning negative and remained asymptomatic. Other patients were followed up on the 3rd, 7th and 14th day after discharge, and no abnormal findings were found. Conclusion Screening/suspected cases of 2019-nCoV infection in children were mostly clinically manifested as respiratory or gastrointestinal symptoms. The diagnosis rate of nucleic acids was extremely low, and there was a possibility of missed diagnosis. Nearly 50% of cases could find other relevant pathogens excluding the 2019-nCoV. The positive rate of anal swab results was higher than that of pharyngeal swab.

目的 探讨急性心肌梗死患者细胞色素P450酶基因(cytochrome P450,family 2,subfamily C,polypeptide 19,CYP2C19)多态性与高敏C-反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白细胞介素-6(interleukin- 6,IL-6)及临床预后的相关性。方法 选取2019年5月—2020年5月入住我院心血管内科的急性心肌梗死患者182例作为研究对象,研究对象均接受经皮冠脉介入术,采取RT-PCR方法进行外周全血CYP2C19基因多态性的检测,并进行分组。口服阿司匹林300 mg和氯吡格雷300 mg后次日,测定血中hs-CRP和IL-6含量,治疗后12个月内,随访主要心血管不良事件。结果 182例急性心肌梗死患者中,快代谢组(CYP2C19*1/*1)患者最多,为78例(42.8%);中等代谢组(CYP2C19*1/*2、CYP2C19*1/*3),为65例(35.7%);慢代谢型组(CYP2C19*2/*2、CYP2C19*2/*3、CYP2C19*3/*3)最少,为39例(21.5%)。与快代谢组比较,中代谢组及慢代谢组hs-CRP、IL-6水平均升高,差异有统计学意义(P<0.05);与中代谢组比较,慢代谢组患者hs-CRP、IL-6水平均升高,差异有统计学意义(P<0.05)。CYP2C19基因型与hs-CRP及IL-6呈正相关(r=0.163、0.175,P<0.05)。中代谢组、慢代谢组患者1年内主要心血管不良事件发生率高于快代谢组患者(P<0.05)。结论 CYP2C19基因型与hs-CRP及IL-6具有相关性,CYP2C19基因型为中代谢型和慢代谢型能够激活机体炎症反应,影响急性心肌梗死患者的临床预后。

Objective To explore the correlation of cytochrome P450 gene (CYP2C19) polymorphism with hypersensitive C-reaction protein (hs-CRP), interleukin-6 (IL-6) and prognosis in patients with acute myocardial infarction (AMI). Methods A total of 182 patients with AMI admitted to cardiology department from May 2019 to May 2020 were selected as the research objects, all subjects underwent percutaneous coronary intervention (PCI), and CYP2C19 gene polymorphism in peripheral blood was detected by RT-PCR, which was grouping basis. One day after taking aspirin 300 mg and clopidogrel 300 mg orally, the levels of hs-CRP and IL-6 in patients' plasma were measured. The major adverse cardiovascular events (MACE) were followed up for 12 months after treatment. Results Among 182 patients with AMI, 78 patients (42.8%) were in the fast metabolism group (CYP2C19*1/*1), 65 patients (35.7%) in medium metabolism group (CYP2C19*1/*2, CYP2C19*1/*3), 39 patients (21.5%) in the slow metabolism group (CYP2C19*2/*2, CYP2C19*2/*3, CYP2C19*3/*3).Compared with the fast metabolism group, hs-CRP and IL-6 levels in the medium and slow metabolism group were significantly higher (P<0.05); compared with the medium metabolism group, hs-CRP and IL-6 levels in the slow metabolism group were significantly increased (P<0.05). CYP2C19 genotype was positively correlated with hs-CRP and IL-6 levels (r=0.163, 0.175,P<0.05). The incidences of MACE in the medium and slow metabolism groups were higher than that in the fast metabolism group (P<0.05). Conclusion CYP2C19 genotypes were associated with hs-CRP and IL-6 levels. Medium and slow metabolism types of CYP2C19 gene can activate the inflammatory response and affect the clinical prognosis of patients with AMI.

目的 系统评价胰岛素联用α-葡萄糖苷酶抑制剂(AGIs)治疗成人1型糖尿病(T1DM)的疗效和安全性。方法 检索中英文数据库,纳入关于胰岛素联用AGIs治疗成人T1DM患者的随机或非随机对照试验。使用Review Manager 5.3软件进行Meta分析。结果 共纳入10项研究,616例患者。与安慰剂或空白对照相比,在有效性方面,胰岛素联合AGIs可改善成人T1DM患者的糖化血红蛋白;降低平均血糖、空腹血糖和餐后2小时血糖;改善血糖波动情况,包括平均血糖波动幅度和最大血糖波动幅度(均P<0.05)。在安全性方面,AGIs增加总不良反应发生的风险(P<0.05),其中主要是胃肠道不适,但未增加低血糖的发生率和发生次数(均P>0.05)。胰岛素联合AGIs减少了每日胰岛素总剂量(P<0.05),但对体重、甘油三酯和高密度脂蛋白胆固醇无显著影响(均P>0.05)。结论 胰岛素联合AGIs可降低成人T1DM患者的糖化血红蛋白,改善血糖水平和血糖波动情况。AGIs不会增加低血糖的风险,但需重视其不良反应,特别是胃肠道不良反应。

Objective To systematically evaluate the efficacy and safety of adding alpha-glucosidase inhibitors (AGIs) to insulin therapy in adult patients with type 1 diabetes (T1DM). Methods Articles about randomized or non-randomized controlled trials of insulin combined with AGIs in adult patients with T1DM were retrieved from Chinese and English database. Meta-analyses were performed by using Review Manager 5.3. Results A total of 616 patients were included from 10 clinical trials. Compared with adding placebo or nothing, in terms of efficacy, the addition of AGIs resulted in decreased HbA1c, mean blood glucose, fasting plasma blood glucose and 2-hour postprandial blood glucose levels (all P<0.05). And this scheme improved the glucose variability including mean amplitude of glycemic excursions and the largest amplitude of glycemic excursions (P<0.05, respectively). As to safety, AGIs increased the risk of total adverse reactions (P<0.05), most of them were gastrointestinal complaints, while the occurrence and the frequency of hypoglycemia were similar (P>0.05, respectively). This scheme could also lead to the reduced total daily insulin dose (P<0.05) but had no significant effect on body weight, triglyceride or cholesterol concentration (P>0.05, respectively). Conclusions The addition of AGIs to insulin therapy in adult patients with T1DM may reduce HbA1c and improve the glucose levels and glucose variability. But total adverse effects especially the gastrointestinal complaints should also be considered in the use of AGIs although it does not increase the risk of hypoglycemia.

目的 探讨p16免疫细胞化学、人乳头瘤病毒(HPV)DNA基因分型单独和联合检测在宫颈细胞学不能明确诊断意义的非典型鳞状上皮细胞(ASC-US)分流中的价值。方法 收集2017年3月—2022年1月,585例液基薄层细胞学(TCT)诊断为ASC-US患者的宫颈细胞学标本,使用免疫细胞化学法行p16蛋白检测,生物芯片法行HPV DNA基因分型检测,患者于8周内行阴道镜下病理活检术。以组织学诊断结果为金标准,探讨p16免疫细胞化学和HPV DNA基因分型单独和联合检测方法在同一级别宫颈病变中阳性率的差异,对比同一检测方法在不同级别宫颈病变中阳性率的差异,比较p16免疫细胞化学、HPV DNA基因分型单独和联合检测对高级别鳞状上皮内病变(HSIL)以上病变诊断效能的差异,综合评定一种最优的ASC-US分流方法。结果 ①(p16+HPV DNA)联合检测在同一级别宫颈病变中阳性率高于p16免疫细胞化学、HPV DNA基因分型检测。②p16免疫细胞化学、HPV DNA基因分型、(p16+HPV DNA)联合检测的阳性率均随着宫颈病变程度的加重而递增。③(p16+HPV DNA)联合检测的综合诊断效能最佳,其灵敏度、特异度、符合率和约登指数分别为99.07%、62.55%、69.23%、0.62。结论 p16免疫细胞化学检测法与HPV DNA基因分型单独和联合检测均有助于ASC-US分流,但是,(p16+HPV DNA)联合检测具有更优的灵敏度和约登指数,同时保持了较高的特异度和符合率,可有效进行ASC-US分流。

Objective To investigate the value of p16 immunocytochemistry and human papillomavirus (HPV) DNA genotyping alone and combined in atypical squamous cells of undetermined significance (ASC-US) shunt which cervical cytology can not clearly diagnose. Methods From March 2017 to January 2022, cervical cytological specimens of 585 patients with ASC-US diagnosed by liquid based thinprep cytology test (TCT) were collected. p16 protein was detected by immunocytochemistry, HPV DNA genotype was detected by biochip and the patients underwent colposcopy pathological biopsy within 8 weeks. Taking the histological diagnosis results as the gold standard, the differences of the positive rate of p16 immunocytochemistry and HPV DNA genotyping in the same level of cervical lesions, differences of the positive rate of the same detection method in different levels of cervical lesions and differenes of p16 immunocytochemistry HPV DNA genotyping alone and combined detection of the diagnostic efficacy of lesions severer than high-grade squamous intraepithelial lesion (HSIL) were compared to comprehensively evaluate an optimal ASC-US shunt method. Results ①The positive rate of combined detection of (p16+HPV DNA) in the same level of cervical lesions was higher than that of differences of p16 immunocytochemistry and HPV DNA genotyping. ②The positive rate of combined detection of (p16+HPV DNA), p16 immunocytochemistry and HPV DNA genotyping increased with the aggravation of cervical lesions. ③The combined detection of (p16+HPV DNA) had the best comprehensive diagnostic efficiency and its sensitivity, specificity, coincidence rate and Yoden index were 99.07%, 62.55%, 69.23% and 0.62 respectively. Conclusions p16 immunocytochemical assay and HPV DNA genotyping, both alone and in combination, contributed to ASC-US shunt. However, the combined detection of (p16+HPV DNA) had better sensitivity and Yoden index, with high specificity and coincidence rate, which can effectively carry out ASC-US shunt.

目的 探究冠心病患者血清同型半胱氨酸(HCY)、血红素加氧酶-1(HO-1)水平与冠状动脉Gensini积分的相关性,并对其进行分析与探讨。方法 随机选取2020年3月—2021年7月于我院心内科行冠脉造影确诊的冠心病患者108例作为观察组和同期于我院行冠脉造影排除冠心病的健康人群33例作为对照组。根据冠心病患者的Gensini积分将其分为低分组(n=42)、中分组(n=35)和高分组(n=31)。对比观察组与对照组2组研究对象血清HCY、HO-1水平差异,冠心病患者的血清HCY、HO-1水平与Gensini积分的相关性通过Pearson相关分析法分析。结果 观察组血清HCY水平高于对照组(P＜0.05);观察组血清HO-1水平低于对照组血清HO-1水平(P＜0.05)。高分组血清HCY水平高于中分组和低分组(P＜0.05);高分组血清HO-1水平低于中分组和低分组(P＜0.05)。血清HCY水平与Gensini积分呈正相关(P＜0.05),血清HO-1水平与Gensini积分呈负相关(P＜0.05)。结论 血清HCY、HO-1水平与冠心病患者Gensini积分密切相关。

Objective To investigate the correlation between serum homocysteine (HCY), heme oxygenase-1 (HO-1) levels and coronary Gensini score in patients with coronary artery disease. Methods One hundred and eight patients with coronary artery disease diagnosed by coronary angiography in the cardiology department of our hospital from March 2020 to July 2021 were randomly included in observation group, while 33 healthy people without coronary artery disease confirmed by coronary angiography in our hospital during the same period as the control group. The 108 patients with coronary artery disease were divided into low (n=42), medium (n=35) and high (n=31) groups by coronary Gensini score. The differences in serum HCY and HO-1 levels between observation group and control group were compared, and the correlation between serum HCY, HO-1 levels and coronary Gensini score was analyzed by Pearson correlation analysis. Results The serum HCY level of the observation group was higher than that of the control group (P<0.05); the serum HO-1 level of the observation group was lower than that of the control group (P<0.05). The serum HCY level in the high group was higher than the middle group and low group (P<0.05); the serum HO-1 level in the high group was lower than the middle group and low group (P<0.05). Serum HCY level was positively correlated with coronary Gensini score (P<0.05), and serum HO-1 level was negatively correlated with coronary Gensini score (P<0.05). Conclusions Serum HCY and HO-1 levels were closely correlated with coronary Gensini score in patients with coronary artery disease.

目的 探究液基细胞学检查联合鳞状上皮细胞癌抗原(SCCA)、癌抗原153(CA153)检测对宫颈癌诊断价值。方法 对子宫颈上皮内瘤变患者54例(内瘤变组)、子宫颈癌患者54例(宫颈癌组)及健康体检者54例(对照组)进行液基细胞学、血清SCCA、血清CA153进行检测,以病理活检诊断为金标准。分析液基细胞学检查、血清中SCCA、血清中CA153对宫颈癌诊断价值,并分析联合液基细胞学检查与血清中SCCA、血清中CA153检测的临床价值。结果 内瘤变组和宫颈癌组血清SCCA、CA153水平均高于对照组,宫颈癌组血清SCCA、CA153水平高于内瘤变组(P均<0.05)。单项检测中,液基细胞学检查阳性率高于SCCA、CA153,联合检测阳性率与其他各单项检测相比明显提高(P<0.05)。结论 宫颈癌患者体内SCCA、CA153水平高,液基细胞学检查联合SCCA、CA153检测对宫颈癌早期阳性检出率高。

Objective To explore the diagnostic value of liquid-based cytology combined with squamous cell carcinoma antigen (SCCA) and cancer antigen 153 (CA153) detection in patients with cervical cancer. Methods Liquid-based cytology, serum SCCA, and serum CA153 were detected on 54 patients with cervical intraepithelial neoplasia (neoplasia group), 54 patients with cervical cancer (cancer group), and 54 healthy subjects (control group). Pathological biopsy diagnosis was used as the gold standard. The diagnostic value of liquid-based cytology, serum SCCA, and serum CA153 in cervical cancer was analyzed, and the clinical value of combining liquid-based cytology with serum SCCA and serum CA153 detection was also analyzed. Results The levels of serum SCCA and CA153 in neoplasia group and cancer group were higher than those in control group, and the serum SCCA and CA153 levels in the cancer group were higher than those in the neoplasia group (P<0.05). In the single detection, the positive rate of liquid-based cytology was higher than that of serum SCCA and CA153, and the positive rate of combined detection was significantly higher than those of the single detection (P<0.05). Conclusions Cervical cancer patients have high levels of serum SCCA and CA153. Liquid-based cytology combined with SCCA and CA153 detection has high positive rate for early cervical cancer.

目的 探讨在COVID-19流行期间血库资源紧张状态下输血时机对儿童输血效果及临床预后的影响。方法 本回顾性队列研究纳入2020年1月—2020年12月在广州市妇女儿童医疗中心儿科急诊就诊并申请输血的患儿的临床预后。结果 共566例发起红细胞和血小板的非手术输血申请的患儿纳入研究,包括 260 例的红细胞申请和306例血小板申请。260份红细胞申请中:209 例及时输血,40 例延时输血,11 例未输血;及时组和延时组的输血有效率分别为37.8%和35.0%(P=0.737);1名不良预后的死亡病例出现在及时组中,余病例临床预后均良好,3组的临床结局无统计学差异(组间P=0.886)。306份血小板申请中:195 例及时输血,108 例延时输血,3例未输血;1名不良预后的死亡病例出现在及时组中(0.51%),3名不良预后的死亡病例出现在延时组中(2.78%),余病例临床预后均良好,3组的临床结局无统计学差异(组间P=0.131)。结论 符合红细胞与血小板输血指征的非急诊手术用血的急诊患儿中,及时组、延时组和未输血组之间的临床结局没有差异。输血时机进一步需要大样本的循证研究加以确定。

Objective To investigate the influence of blood transfusion timing on blood transfusion efficacy and clinical prognosis in children under the strain of blood bank resources during COVID-19 pandemic. Methods This retrospective cohort study included clinical outcomes of pediatric emergency patients who applied for blood transfusion in Guangzhou Women and Children's Hospital from January 2020 to December 2020. Results A total of 566 children applicated blood transfusion for red blood cells and platelets for non-emergency surgical use were enrolled, including 260 red blood cells cases and 306 platelets cases. Among the 260 applications for red blood cells, 209 cases received timely transfusion, 40 cases received delayed transfusion, and 11 cases did not receive transfusion.The effective rate of transfusion for red blood cells was 37.8% in the timely group and 35.0% in the delayed group (P=0.737). One death case with poor prognosis was found in the timely transfusion group, and the clinical prognosis of the rest cases was good. There was no statistical difference in the clinical outcomes among the three groups (P=0.886). Among 306 applications for platelet, 195 cases had timely transfusion, 108 cases had delayed transfusion, and 13 cases did not had transfusion.One case with poor prognosis died in the timely transfusion group (0.51%), and three with poor prognosis died in the delayed transfusion group (2.78%). The rest of the cases had good clinical prognosis, and there was no statistical difference in clinical outcomes among the three groups (P=0.131). Conclusions There were no significant differences in clinical outcomes among the timely transfusion group, the delayed transfusion group, and the non-transfusion group for red blood cell and platelet transfusion respectively. The timing of transfusion may need to be determined by evidence-based studies with large samples.

目的 分析探讨健康驿站新冠病毒肺炎病例感染来源,评估驿站站内感染风险,规范驿站管理,降低感染风险。方法 对驿站2022年2月21日—3月9日全部14例新冠肺炎病例自入境到报告进行全链条风险分析。结果 14例病例为7批次不同时间入住,其中病例1、2、3、4、5、6、7、8、9、10、12、13共12例病例入境后即确诊,病例11入住5天(其共同入境、同住人员病例10,入境后即确诊)确诊、病例14入住10天发病确诊,其余病例均未呈现感染发病时间特异性,未呈现入境后交叉感染时间特异性,未见入住后空间、通风系统、排污系统交集,未见交叉感染情况。结论 该驿站目前报告新冠肺炎病例均有相关旅居史,主要在香港本土感染。13名病例大概率均在香港感染,入境隔离时发病确诊,其中病例1、2、3、4,病例6、7、8,病例10、11是3起呈现家庭聚集性感染发病,病例5、9是独立个案,病例14需要进一步排除,驿站未规范管理会导致误报及进一步扩大站内感染风险。

Objective To investigate and analyze the source of infection of COVID-19 cases in health station, assess the risk of infection, standardize the management and reduce the risk of infection. Methods From February 21 to March 9, 2022, the whole chain risk analysis of all 14 COVID-19 cases from entry to reporting was carried out. Results Fourteen cases were admitted in 7 batches at different times. Except for case 11 who diagnosed at the 5th day (the case of co-entry and co-resident case 10 was diagnosed after entry), and case 14 who diagnosed at the 10th day, the rest of the cases were diagnosed after entry, which did not show infection-onset time specificity, no time specificity of cross-infection after entry, no intersection of space, ventilation system and sewage system after entry, and no cross-infection. Conclusions The COVID-19 cases reported by the station were mainly infected in Hong Kong. Those 13 cases were highly likely infected in Hong Kong, all were diagnosed at the time of entry quarantine, while cases 1~4, cases 6~8, and cases 10~11 were 3 cases of family cluster infection, case 5 and 9 were an independent case, and case 14 needed to be further investigation. Failure to standardize the management of the station will lead to false alarms and further increase the risk of infection in the station.