简介：摘要爆炸伤是爆炸产生的高速碎片、原发冲击波等直接作用于机体造成的损伤，多见于战争、高压锅炉、液化气罐或化学物品贮罐爆炸等，具有突发性、成批性、伤情复杂、多变性等特点。胸部是爆炸最常见的损伤部位之一，肺是爆炸伤作用的重要靶器官，表现外轻内重、程度重、较隐匿、伤情发展迅速。本文综述肺爆炸伤的损伤机制、流行病学分型、临床表现、影像学检查，重点阐述肺爆炸伤院内早期救治策略。

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简介：摘要目的回顾性分析新型冠状病毒肺炎(COVID-19)患者的临床资料，认识重症COVID-19患者的临床特征，切实指导临床实际工作。方法总结分析2020年1月28日至2020年2月12日于北京佑安医院住院治疗的确诊为COVID-19重型、危重型19名患者的临床资料，包括患者年龄、性别、病程、流行病学史、既往史、临床症状、实验室检查、肺部CT表现、治疗以及临床结局。统计学处理采用SPSS 22.0软件。结果被纳入本研究的19名患者，重型10例、危重型9例；年龄58～94岁，平均75岁；男性10人、女性9人。病程从1～14 d不等，病程中位数5 d。4人有明确的武汉居住史、13人与确诊患者有密切接触者(包括家庭聚会、共餐、同居一室等)、2人无相关的流行病学史。14人患有慢性基础病(其中高血压病11例、冠心病4例、心功能不全4例、慢阻肺3例、陈旧性前壁心梗2例、心律失常3例、心脏瓣膜病1例、糖尿病2例、慢性肾病2例等)，4例患者同时合并3种及以上基础病。首发症状主要为发热18例、咳嗽13例、呼吸困难8例。就诊时17例患者伴有淋巴细胞计数低于正常范围，11例有不同程度的肝脏功能异常，10例患者心肌酶谱异常，7名患者不同程度的肾功能损害。18名患者C-反应蛋白升高。12例接受激素治疗，4例接受丙球治疗，无创呼吸机机械通气3例，有创呼吸机协助通气7例。1例患者接受持续血液净化(continuous renal replacement therapy，CRRT)治疗，1例患者接受体外膜肺氧合(extracorporeal membrane oxygenation，ECMO)治疗；截至2020年2月17日，10例患者病情好转，4例患者仍在ICU治疗，5例患者死亡。结论老年人以及合并有慢性基础疾病患者更易发展为重型、危重型病例。淋巴细胞计数降低、C-反应蛋白水平升高、肝肾功能及心肌酶谱异常与重症化相关。激素及呼吸机治疗重症有效。

简介：摘要：近年来随着粉尘工业的快速发展，粉尘爆炸事件多发。本文从粉尘的定义、机理、条件以及特点等方面，分析了粉尘爆炸的基本特征、粉尘爆炸的模式及粉尘事故发生的主要因素，其中包括粉尘的状态、自身的可燃性以及所处的环境；文中列举了粉尘爆炸的预防措施，如减少粉尘暴露、从助燃剂方面进行预防、从可燃物方面进行预防、控制和杜绝点火源等四个方面，旨在对今后粉尘工业的生产有一定的指导作用和参考价值。

简介：摘要：作为大型制氧工业中的重要组成部分，空分塔直接关系到氧气的制备质量与速度，确保空分塔安全运行，可以为整个制氧工业的发展提供重要帮助。基于此，本文通过对空分塔爆炸因素的深入介绍，进而分析了空分塔分类及其安全性， 并以此为基础，阐述了预防爆炸的具体措施，以使空分塔可以安全、有效的运行。

简介：摘要：易燃气体存在意外爆炸的危险，而对该类事故的分析中，爆炸能量显得尤为重要，而目前理论或实验室数据较少。本文针对该问题，进行了几种理论的推算，并对事故的分析及安全工作的提出了指导性的建议。

简介：摘要Coronavirus disease (COVID-19), the infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported on December 31, 2019. Because it has only been studied for just over three months, our understanding of this disease is still incomplete, particularly regarding its sequelae and long-term outcomes. Moreover, very little has been written about the rehabilitation needs of patients with COVID-19 after discharge from acute care. The objective of this report is to answer the question " What rehabilitation services do survivors of COVID-19 require？" The question was asked within the context of a subacute hospital delivering geriatric inpatient and outpatient rehabilitation services. Three areas relevant to rehabilitation after COVID-19 were identified. First, details of how patients may present have been summarized, including comorbidities, complications from an intensive care unit stay with or without intubation, and the effects of the virus on multiple body systems, including those pertaining to cardiac, neurological, cognitive, and mental health. Second, I have suggested procedures regarding the design of inpatient rehabilitation units for COVID-19 survivors, staffing issues, and considerations for outpatient rehabilitation. Third, guidelines for rehabilitation (physiotherapy, occupational therapy, speech-language pathology) following COVID-19 have been proposed with respect to recovery of the respiratory system as well as recovery of mobility and function. A thorough assessment and an individualized, progressive treatment plan which focuses on function, disability, and return to participation in society will help each patient to maximize their function and quality of life. Careful consideration of the rehabilitation environment will ensure that all patients recover as completely as possible.

简介：AbstractCoronavirus disease 2019 (COVID-19) is a newly emerged infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The number of COVID-19 cases is continuously increasing and no effective drugs or vaccines are currently available. Accurate and efficient diagnostic testing methods are desperately needed for the detection of SARS-CoV-2 and antiviral antibodies in infected individuals. Various assay techniques, including nucleic acid tests [eg, polymerase chain reaction (PCR), reverse transcription-PCR, real-time loop-mediated isothermal amplification, and CRISPR-Cas-based detection], serological tests [eg, immunoglobulin (Ig)A, IgM/G], imaging tests (eg, computed tomography and positron-emission tomography), and nanoparticle-based detections have been reported for COVID-19 diagnosis. This review aims to present the current diagnostic tools for SARS-CoV-2 and their performance characteristics to inform the appropriate selection of diagnostic and surveillance technologies at optimal testing times. We also describe the advantages of detection using combined nucleic acid and imaging tests, or serological testing and point-of-care diagnostics. Developing reliable protein biomarkers targeting the conserved proteins of SARS-CoV-2 rather than IgA, IgM, or IgG would be useful to manage SARS-CoV-2.

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简介：AbstractSince the outbreak of the novel coronavirus in Wuhan, China, as obstetricians, we also face great challenges. We need to identify pregnant patients with 2019 coronavirus disease infection timely, and give them appropriate treatment in order to obtain a good maternal and infant prognosis. Here, we would like to share a case and provide some suggestions on how to screen, diagnose and treat pregnant women with 2019 coronavirus disease infection during the outbreak.

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简介：AbstractIntroduction:The transmission pathways of coronavirus disease 2019 (COVID-19) remain not completely clear. In this case study the test for the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pharyngeal swab and anal swab were compared.Case presentation:A 3-month-old girl was admitted to our hospital with COVID-19. Her parents had both been diagnosed with COVID-19. The results of pharyngeal swab and anal swab of the little girl were recorded and compared during the course of the disease. The oropharyngeal specimen showed negative result for SARS-CoV-2 on the 14th day after onset of the illness. However, the anal swab was still positive for SARS-CoV-2 on the 28th day after the onset of the illness.Conclusion:The possibility of fecal-oral transmission of COVID-19 should be assessed. Personal hygiene during home quarantine merits considerable attention.

简介：摘 要 ：民爆物品安全监管，是公安工作的重要组成部分。为防止民爆物品流失和涉爆案事件的发生，加强民爆物品管理尤为重要。在民爆物品管理中， 民爆生产企业作为主体单位，要不断 加强自身队伍建设、提高管理水平，又 生产、销售、爆破服务等相关单位 落实各项制度，做到安全生产，确保民爆物品不流失。本文对民用爆炸物品安全监管对策进行分析。

简介：摘要BACKGROUNDCoronavirus disease 2019 (COVID-19) caused by a new Betacoronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently a global pandemic. Gathered clinicopathological evidence in COVID-19 patients shows that alveoli injuries and interstitial changes are the major mechanisms of impaired O2/CO2 exchange. Few rehabilitation exercises concerning COVID-19 patients were reported. Here, we present a modified version of rehabilitation exercises based on the underlying mechanism of the disease to mild cases of COVID-19. These exercises aimed to improve the pulmonary function of patients and ease the expectoration process. Additionally, an essential branch of Traditional Chinese Medicine (TCM) named acupressure was integrated into the exercises to facilitate the recovery and maintenance of pulmonary function.METHODSFrom March 4, 2020 to May 5, 2020, a total of 60 COVID-19 patients who completed the full course of MRE were enrolled in this observational study. The diagnostic and classification criteria were based on the 7th edition of Diagnosis and Treatment Guideline of COVID-19 published by the National Health Commission of the People′s Republic of China. We prospectively gathered patients′ reported outcomes concerning respiration-related symptoms at four different time points, including: (I) at admission; (II) at the time of hospital discharge; (III) two weeks after discharge; (IV) four weeks after discharge. The reported respiratory symptoms included dry cough, productive cough, difficulty in expectoration, and dyspnea.RESULTSIn total, 60 confirmed mild COVID-19 cases were enrolled with a median age of 54 years old. The baseline prevalence for dry cough, productive cough, difficulty in expectoration, and dyspnea were 41.7%, 43.3%, 35.0%, and 50.0%, respectively. The pronounced decline in symptom prevalence was recorded over time. Interestingly, four weeks after discharge, we noticed a lower remission rate in productive cough and difficulty in expectoration.CONCLUSIONThe modified rehabilitation exercises were retrieved from the Eight-Section Brocade, and are specifically designed for rehabilitation of COVID-19 patients at home or health facilities. Based on current findings on pronouncedly improved remission rate in respiratory symptoms, we recommend the MRE as suitable rehabilitation exercise to smooth respiration and ease the expectoration process in mild COVID-19 cases.

简介：摘要This analysis extrapolates information from prior studies and experiences to bring PM&R perspective and intervention to the multidisciplinary treatment of COVID-19. The purpose of pulmonary rehabilitation in COVID-19 patients is to improve symptoms of dyspnea, relieve anxiety, reduce complications, minimize disability, preserve function and improve quality of life. Pulmonary rehabilitation during the acute management of COVID-19 should be considered when possible and safe and may include nutrition, airway, posture, clearance technique, oxygen supplementation, breathing exercises, stretching, manual therapy, and physical activity. Given the possibility of long-term disability, outpatient post-hospitalization pulmonary rehabilitation may be considered in all patients hospitalized with COVID-19.

简介：摘要The COVID-19 pandemic affects a large number of patients with a rapid progression of respiratory failure often requiring hospitalization or intensive care unit treatment in some patients. Survivors of severe COVID-19 suffer from persistent weakness and cardiorespiratory failure. Feasibility and potential benefit of cardiopulmonary rehabilitation (CR) after COVID-19 remains unclear. Therefore, we retrospectively analyzed a cohort of COVID-19 patients in a single center inpatient rehabilitation clinic and describe performance and outcome during CR.Patients were referred from acute care hospitals for rehabilitation after severe COVID-19. The cohort (n＝28) was divided in ventilated or not ventilated patients for further analysis. 50% were female, mean age was 66 years and patients stayed in the acute hospital for 19.3±10.7 days before referral for CR. 17 patients (61%) needed previous ICU treatment in the acute care hospital. Risk factors, assessments and questionnaires on admission were comparable in both groups. Significant enhancements were observed in 6-minute walking test and Feeling Thermometer which were independent of previous ventilation status.In conclusion, comprehensive CR following COVID-19 is safe, feasible and effective. Improvements in physical performance and subjective health status were independent of previous ventilation.

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简介：AbstractThis study aimed to determine the clinical characteristics of patients diagnosed with the coronavirus disease 2019 (COVID-19). Clinical data of COVID-19 patients diagnosed between January 28, 2020 and February 23, 2020 at the Beijing You'an Hospital were summarized and analyzed. Overall, 45 (18 men and 27 women) patients were included in this study. The average age of patients was 58 years (range, 7–94 years). Furthermore, 21 patients (47%) experienced underlying chronic diseases, with another four patients (9%) having three or more chronic diseases simultaneously. The first symptoms appeared at the onset of illness onset include fever in 36 patients (80%), cough in 23 patients (51%), and expectoration in 15 patients (33%), respectively. Patients may experience hepatic and renal injury as well as abnormal myocardial enzymes in varying degrees. Senior patients (≥58) and accompanying chronic diseases were considered as independent predictors for developing a severe and critically ill population with increased mortality. Laboratory results regarding the NEU percentage, NLR, ALC, and C-reactive protein levels were considered significant in predicting clinically critical disease or for prognosis assessment and thus require further studies. COVID-19 may affect multiple organs of the human body. Glucocorticoid is considered effective in the treatment of patients diagnosed with severe COVID-19.