Expert Consensus on Disaster Medical Rescue Services

Disasters and disaster rescue are accompanied by the development of human history. But disaster medicine has been a discipline only for several decades recently. The establishment of the disaster rescue system in China began with the outbreak of SARS in 2003. As the incident exposed a series of problems in response to emerging infectious diseases, China began to consider how to systematically respond to various disasters and commence establishing a comprehensive emergency management system. The “Emergency Response Law of the People’s Republic of China” implemented in 2007 marks the preliminary establishment of China’s modern disaster rescue system. In December 2011, the Disaster Medicine Branch of Chinese Medical Association was established in Shanghai, marking a new stage of the development of disaster medicine in China. Here, disaster medicine and medical rescue services were summarized to guide the implementation of related work.

Assessing the outcome of management of thyroid dysfunction in pregnancy with second affiliated hospital of Chongqing Medical University guideline.

Pregnancy comes with hormonal changes which, when not properly managed, could lead to complications. Thyroid hormone is one of the hormones that are affected during pregnancy, and it plays a significant role in pregnancy, from conception to delivery. In a bid to identify intended pregnant women and pregnant women with thyroid dysfunction, the Endocrinology Branch of Chinese Medical Association and Perinatal medicine branch of Chinese Medical Association set guidelines for diagnosis and treatment of thyroid diseases in pregnancy and postpartum women. The guideline recommends screening for all women who desire getting pregnant soon and pregnant women, which Second Affiliated Hospital of Chongqing Medical University is implementing. This study was carried out to Identify the common thyroid disease found among pregnant women in Chongqing, evaluate the effectiveness of the management guideline toward improving pregnancy outcome among women diagnosed with thyroid disease during their pregestational and gestational period, and ascertain the need for additional measures to be taken towards thyroid disease management during pregnancy in certain areas with unfavourable outcome. Our findings showed an association between maternal age and abortion among pregnant women diagnosed with subclinical hypothyroidism, P-0.018(OR 1.459, 95%CI 1.067–1.997) and significant difference in pregnant women who developed intrauterine growth restriction after being diagnosed with hypothyroidism in the second trimester, P-0.048(OR-0.152, 95%CI 0.024–0.981). There was also a significant difference in gravida, P-0.032(OR 1.368, 95%CI 1.028 1.821) and normal delivery mode, P-0.010(OR 2.521, 95%CI 1.246-5.100). The study shows a promising result as less complication is observed. However, more attention is needed toward managing subclinical hypothyroidism in pregnancy to curb abortion/miscarriage incidence. Hypothyroidism in second trimester could lead to intrauterine growth restriction. Multigravida increases the risk of complication among pregnant women with thyroid dysfunction.

Assessing the Outcome of Management of Thyroid Dysfunction in Pregnancy With Second Affiliated Hospital of Chongqing Medical University Guideline.

Introduction – Pregnancy comes with hormonal changes which, when not properly managed, could lead to complications. Thyroid hormone is one of the hormones that are affected during pregnancy, and it plays a significant role in pregnancy, from conception to delivery. In a bid to identify intended pregnant women and pregnant women with thyroid dysfunction, the Endocrinology Branch of Chinese Medical Association and Perinatal medicine branch of Chinese Medical Association set guidelines for diagnosis and treatment of thyroid diseases in pregnancy and postpartum women. The guideline recommends screening for all women who desire getting pregnant soon and pregnant women, which Second Affiliated Hospital of Chongqing Medical University is implementing.Purpose - To Identify the common thyroid disease found among pregnant women in Chongqing. Evaluate the effectiveness of the management guideline toward improving pregnancy outcome among women diagnosed with thyroid disease during their pregestational and gestational period, and ascertain the need for additional measures to be taken towards thyroid disease management during pregnancy in certain areas with unfavourable outcome.Method – A retrospective cohort study of 774 pregnant women diagnosed with thyroid dysfunction in the Second Affiliated Hospital of Chongqing Medical University from 2016 -2018 was extracted from the hospital computer patient’s record. Only 724 patients that met the inclusive criteria were analysed. Participants were grouped into four, according to the time they were diagnosed and managed. The Multiple logistic regression and binary logistic regression statistical analysis were done with SPSS, and we adjusted for potential confounders, including maternal age, parity, and gravida.Result – There is an association between maternal age and abortion among pregnant women diagnosed with subclinical hypothyroidism, P-0.018(OR 1.459, 95%CI 1.067-1.997) and significant difference in pregnant women who developed intrauterine growth restriction after being diagnosed with hypothyroidism in the second trimester, P-0.048(OR-0.152, 95%CI 0.024-0.981). There was also a significant difference in gravida, P-0.032(OR 1.368, 95%CI 1.028 1.821) and normal delivery mode, P-0.010(OR 2.521, 95%CI 1.246-5.100).Conclusion – The study shows a promising result as less complication is observed. However, more attention is needed toward managing subclinical hypothyroidism in pregnancy to curb abortion/miscarriage incidence. Hypothyroidism in second trimester could lead to intrauterine growth restriction. Multigravida increases the risk of complication among pregnant women with thyroid dysfunction.

Nutritional Support in Coronavirus 2019 Disease

The epidemic that broke out in Chinese Wuhan at the beginning of 2020 presented how important the rapid diagnosis of malnutrition (elevating during intensive care unit stay) and the immediate implementation of caloric and protein-balanced nutrition care are. According to specialists from the Chinese Medical Association for Parenteral and Enteral Nutrition (CSPEN), these activities are crucial for both the therapy success and reduction of mortality rates. The Chinese have published their recommendations including principles for the diagnosis of nutritional status along with the optimal method for nutrition supply including guidelines when to introduce education approach, oral nutritional supplement, tube feeding, and parenteral nutrition. They also calculated energy demand and gave their opinion on proper monitoring and supplementation of immuno-nutrients, fluids and macronutrients intake. The present review summarizes Chinese observations and compares these with the latest European Society for Clinical Nutrition and Metabolism guidelines. Nutritional approach should be an inseparable element of therapy in patients with COVID-19.