目的系统评价重症监护病房(ICU)患者新型冠状病毒感染(COVID-19)相关肺曲霉病(CAPA)感染危险因素。方法计算机检索PubMed、Cochrane Library、Embase、Web of Science、中国知网(CNKI)、万方数据、维普数据库(VIP)中关于ICU患者CAPA感...目的系统评价重症监护病房(ICU)患者新型冠状病毒感染(COVID-19)相关肺曲霉病(CAPA)感染危险因素。方法计算机检索PubMed、Cochrane Library、Embase、Web of Science、中国知网(CNKI)、万方数据、维普数据库(VIP)中关于ICU患者CAPA感染危险因素的研究,检索时限均为建库至2025年3月31日。由2名研究者独立筛选文献与提取资料,采用纽卡斯尔-渥太华(NOS)量表进行质量评价,使用RevMan 5.4软件进行Meta分析。结果共纳入38篇观察性研究,包括11312例患者。Meta分析结果显示,男性、年龄、吸烟、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ评分)、简化急性生理学评分Ⅱ(SAPSⅡ评分)、肝硬化、糖尿病、慢性阻塞性肺疾病(COPD)、心血管疾病、EORTC/MSGERC宿主因素、实体器官移植、血液系统恶性肿瘤、长期使用糖皮质激素、免疫缺陷、Charlson合并症指数、使用血管活性药物和/或正性肌力药物、接受机械通气、侵入性机械通气、机械通气时间、肾脏替代治疗、白细胞介素-6(IL-6)抑制剂治疗等因素均为ICU患者CAPA感染危险因素。身体质量指数(BMI)高和肥胖均为ICU患者CAPA感染的保护性因素(均P<0.05)。结论ICU患者CAPA感染危险因素较多,及时识别相关危险因素有助于尽早实施规范的抗真菌治疗,从而改善患者预后。展开更多
Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unpr...Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unprecedented complexity,particularly in the post-COVID-19 era.This review synthesizes evidence from the past decade(2015-2024)to systematically elucidate how key environmental drivers modulate pathogen emergence,transmission dynamics,and clinical outcomes,with a focus on underlying mechanistic pathways.Specifically,we highlight:(1)the temperature-and precipitation-dependent transmission of vector-borne diseases(e.g.,malaria,dengue)via expanded vector habitats and accelerated pathogen incubation;(2)the exacerbation of respiratory infections(including COVID-19)by particulate matter(PM2.5)and nitrogen dioxide(NO2)through impaired mucosal immunity and enhanced inflammatory responses;(3)the persistence of diarrheal diseases in low-and middle-income countries(LMICs)linked to water insecurity and climate-induced infrastructure failure;and(4)zoonotic spillover risks amplified by urbanization and deforestation-driven human-wildlife interface disruption.Integrating the One Health socioecological framework,we further summarize methodological advances from high-resolution genomic surveillance to climate-informed machine learning models that have improved causal inference and predictive accuracy.Our synthesis confirms that environmental factors are not merely contextual but central,modifiable determinants of infectious disease risk,with disproportionate impacts on vulnerable populations.To mitigate future threats,we emphasize the urgency of interdisciplinary collaboration,integrated environmental-health monitoring platforms,and climate-resilient public health policies tailored to post-pandemic challenges.This review provides a timely roadmap for translating environmental epidemiology insights into actionable strategies to strengthen global health resilience.展开更多
目的观察温针灸联合刺络拔罐治疗轻型新型冠状病毒(corona virus disease 2019,COVID-19)感染患者的临床疗效。方法将82例COVID-19轻型患者随机分为治疗组和对照组,每组41例。对照组予连花清瘟颗粒口服,治疗组在对照组基础上给予温针灸...目的观察温针灸联合刺络拔罐治疗轻型新型冠状病毒(corona virus disease 2019,COVID-19)感染患者的临床疗效。方法将82例COVID-19轻型患者随机分为治疗组和对照组,每组41例。对照组予连花清瘟颗粒口服,治疗组在对照组基础上给予温针灸联合刺络拔罐治疗。比较两组退热时间,两组治疗前后咳嗽视觉模拟量表(visual analog scale,VAS)、中文版莱塞斯特咳嗽生命质量问卷(Mandarin Chinese version of the Leicester cough questionnaire,LCQ-MC)、咽干/痛缓解程度,并比较两组安全性情况,追踪观察两组患者是否出现“长新冠综合征”和COVID-19二次感染情况。结果两组退热时间比较差异有统计学意义(P<0.05)。两组治疗后咳嗽VAS评分低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。两组治疗后LCQ-MC评分低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。两组治疗后咽干/痛程度分布优于治疗前,且治疗组优于对照组,差异有统计学意义(P<0.05)。两组“长新冠综合征”发生率比较差异无统计学意义(P>0.05)。两组COVID-19二次感染率比较差异无统计学意义(P>0.05)。两组疗法安全性均可。结论在口服中成药的基础上,温针灸联合刺络拔罐治疗COVID-19轻型患者在急性期临床疗效显著,安全性高。展开更多
文摘目的系统评价重症监护病房(ICU)患者新型冠状病毒感染(COVID-19)相关肺曲霉病(CAPA)感染危险因素。方法计算机检索PubMed、Cochrane Library、Embase、Web of Science、中国知网(CNKI)、万方数据、维普数据库(VIP)中关于ICU患者CAPA感染危险因素的研究,检索时限均为建库至2025年3月31日。由2名研究者独立筛选文献与提取资料,采用纽卡斯尔-渥太华(NOS)量表进行质量评价,使用RevMan 5.4软件进行Meta分析。结果共纳入38篇观察性研究,包括11312例患者。Meta分析结果显示,男性、年龄、吸烟、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ评分)、简化急性生理学评分Ⅱ(SAPSⅡ评分)、肝硬化、糖尿病、慢性阻塞性肺疾病(COPD)、心血管疾病、EORTC/MSGERC宿主因素、实体器官移植、血液系统恶性肿瘤、长期使用糖皮质激素、免疫缺陷、Charlson合并症指数、使用血管活性药物和/或正性肌力药物、接受机械通气、侵入性机械通气、机械通气时间、肾脏替代治疗、白细胞介素-6(IL-6)抑制剂治疗等因素均为ICU患者CAPA感染危险因素。身体质量指数(BMI)高和肥胖均为ICU患者CAPA感染的保护性因素(均P<0.05)。结论ICU患者CAPA感染危险因素较多,及时识别相关危险因素有助于尽早实施规范的抗真菌治疗,从而改善患者预后。
基金the Natural Science Basic Research Program of Shaanxi Province,China[2023-JC-QN-0858]the Free Exploration Program of the Second Affiliated Hospital,School of Medicine,Xi’an Jiaotong University[2020YJ(ZYTS)605]the National Natural Science Foundation of China[81900620].
文摘Global environmental changes including climate warming,extreme weather events,ambient air pollution,freshwater contamination,and landscape transformation are reshaping the epidemiology of infectious diseases with unprecedented complexity,particularly in the post-COVID-19 era.This review synthesizes evidence from the past decade(2015-2024)to systematically elucidate how key environmental drivers modulate pathogen emergence,transmission dynamics,and clinical outcomes,with a focus on underlying mechanistic pathways.Specifically,we highlight:(1)the temperature-and precipitation-dependent transmission of vector-borne diseases(e.g.,malaria,dengue)via expanded vector habitats and accelerated pathogen incubation;(2)the exacerbation of respiratory infections(including COVID-19)by particulate matter(PM2.5)and nitrogen dioxide(NO2)through impaired mucosal immunity and enhanced inflammatory responses;(3)the persistence of diarrheal diseases in low-and middle-income countries(LMICs)linked to water insecurity and climate-induced infrastructure failure;and(4)zoonotic spillover risks amplified by urbanization and deforestation-driven human-wildlife interface disruption.Integrating the One Health socioecological framework,we further summarize methodological advances from high-resolution genomic surveillance to climate-informed machine learning models that have improved causal inference and predictive accuracy.Our synthesis confirms that environmental factors are not merely contextual but central,modifiable determinants of infectious disease risk,with disproportionate impacts on vulnerable populations.To mitigate future threats,we emphasize the urgency of interdisciplinary collaboration,integrated environmental-health monitoring platforms,and climate-resilient public health policies tailored to post-pandemic challenges.This review provides a timely roadmap for translating environmental epidemiology insights into actionable strategies to strengthen global health resilience.
文摘目的观察温针灸联合刺络拔罐治疗轻型新型冠状病毒(corona virus disease 2019,COVID-19)感染患者的临床疗效。方法将82例COVID-19轻型患者随机分为治疗组和对照组,每组41例。对照组予连花清瘟颗粒口服,治疗组在对照组基础上给予温针灸联合刺络拔罐治疗。比较两组退热时间,两组治疗前后咳嗽视觉模拟量表(visual analog scale,VAS)、中文版莱塞斯特咳嗽生命质量问卷(Mandarin Chinese version of the Leicester cough questionnaire,LCQ-MC)、咽干/痛缓解程度,并比较两组安全性情况,追踪观察两组患者是否出现“长新冠综合征”和COVID-19二次感染情况。结果两组退热时间比较差异有统计学意义(P<0.05)。两组治疗后咳嗽VAS评分低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。两组治疗后LCQ-MC评分低于治疗前,且治疗组低于对照组,差异有统计学意义(P<0.05)。两组治疗后咽干/痛程度分布优于治疗前,且治疗组优于对照组,差异有统计学意义(P<0.05)。两组“长新冠综合征”发生率比较差异无统计学意义(P>0.05)。两组COVID-19二次感染率比较差异无统计学意义(P>0.05)。两组疗法安全性均可。结论在口服中成药的基础上,温针灸联合刺络拔罐治疗COVID-19轻型患者在急性期临床疗效显著,安全性高。
