Author： Group of Obstetric Anesthesia of Chinese Society of Anesthesiology

Abstract： Obstetric anesthesia is an important part of clinical anesthesia during the COVID-19 epidemic. Obstetric anesthesia management faces challenges such as difficulty in evaluation, in managing patients with emergent or fluctuating conditions, and in taking care of both the mother and the fetus/newborn. Obstetric anesthesia should focus on the following aspects. First, detailed evaluation of COVID-19 should be carried out. Except for epidemic-related evaluation, the effect of physiologic changes during pregnancy and complex condition of the parturient and critical condition on COVID-19 evaluation should be considered. The possible effects of maternal lung conditions on the fetus should be paid attention to simultaneously to determine the optimal timing for delivery, delivery mode and degree of protection. Second, tight infection control of the environment, staff and devices is necessary. Delivery of the suspected or diagnosed cases of novel coronavirus infection should be performed in an isolation delivery room or in a negative pressure operating room. Anesthetic personnel should be minimized, and skilled anesthetists should be arranged in priority. Medical staff should wear personal protective equipment according to standards. Third, the keypoint of optimizing anesthesia management is to maintain sufficient oxygenation and stable circulation. For neuraxial anesthesia, coughing and hypotension should be minimized. For general anesthesia, protection from infection during airway management is essential. Fourth, humanistic care should be implemented, and psychological health education and psychological crisis intervention should be conducted for parturients. Fifth, though no evidence supported the vertical transmission yet, the newborn of the suspected or diagnosed mother of novel coronavirus infection should be isolated, and breastfeeding is not permitted until the mother recover. To minimize the risk of infection and optimize clinical safety, multi-discipline-based teamwork by the obstetricians, anesthetists, neonatologists, infect-control experts and intensive care unit staff on infection control and maternal-fetal management is important.

Journal：Chinese Journal of Anesthesiology

Publishing Time：2020,40:E012-E012

DOI：10.3760/cma.j.issn.0254-1416.2020.0012

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Abstract：国家卫生健康委员会发布《新型冠状病毒肺炎诊疗方案（试行第七版）》，首次将病理变化纳入其中。这些病理变化信息是基于当时所获得的有限病例病理观察（重庆和武汉共7例遗体穿刺、5例系统尸检）结果，经过多名病理专家和临床专家讨论总结并达成共识，是目前较为全面的新型冠状病毒感染疾病（COVID-19）病理变化的总结，是COVID-19诊疗方案的重要指导性指标。本文根据COVID-19病理学研究结果，结合严重急性呼吸综合征（SARS）的病理变化，对两种疾病的多器官病理变化进行了比较分析，发现COVID-19与SARS导致的机体病理变化大致相同，主要病变发生在肺、免疫系统（脾脏、淋巴结）及各器官的血管，但SARS肺、脾脏及各器官的血管病变严重且广泛，而COVID-19 Ⅱ型肺泡上皮细胞的增生不如SARS显著，肺内支气管内甚至肺泡腔内可见较多支气管栓，SARS则少见，这可能是通气和换气功能障碍的直接而重要的病理基础，关于COVID-19病理变化，由于掌握的材料有限，尚需将来积累更多的尸体解剖资料予以补充，目前相关的病理变化信息仅供参考。.

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DOI：10.3760/cma.j.cn112151-20200318-00221

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Abstract：During the coronavirus pneumonia (NCP) outbreak, the transportation industries are faced with the more burdensome tasks of outbreak prevention and control as well as ensuring smooth transportation. It is important to organize transportation in order to restore the order of production and life, ensure the normal economic and social operation, and control the outbreak in the whole society. From the perspective of health, this guideline puts forward technical requirements on the operation management, personnel requirements and health protection of passenger transportation places such as aviation, railway, subway, bus, taxi, ship, etc., which reduces the impact of the NCP outbreak on the transportation industry and personal health risks. 在新冠肺炎流行期间，交通运输行业面临的疫情防控和保通保畅运工作任务更加繁重，有序做好返程人员运输组织工作对恢复生产生活秩序、保障经济社会正常运转以及做好全社会疫情防控工作均具有十分重要的意义。本指南从卫生健康角度对客运场所及航空、铁路、地铁、公交、长途车、出租车、船舶等交通运输工具的运行管理、人员要求及卫生防护等方面提出了技术要求，降低新冠肺炎流行对交通运输行业的影响和人员的健康风险。.

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DOI：10.3760/cma.j.cn112150-20200217-00130

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Abstract：A recent epidemic of pneumonia cases in Wuhan China was caused by a novel coronavirus with strong infectivity, the 2019 novel coronavirus (2019-nCoV). The article provides the pulmonary rehabilitation (PR) methods in the principle of 4S (simple, safe, satisfy, save) for patients with pneumonia caused by the novel coronavirus, shows how to establish a ventilative and convectional PR environment to prevent the spread of virus through droplets, how to guide the patients to carry out PR, how to carry out respiratory muscle training, effective cough, expectoration, sneeze, general exercise, digestive function rehabilitation and psychological rehabilitation, and how to clean and disinfect the PR environment. 2019新型冠状病毒（2019-nCoV）感染的肺炎具有高度传染性，本文结合4S（simple，safe，satisfy，save）呼吸康复内容和2019新型冠状病毒肺炎的诊治标准，对2019-nCoV所致的肺炎患者提供可行的呼吸康复指引。.

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DOI：10.3760/cma.j.issn.1001-0939.2020.0004

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DOI：10.3760/cma.j.issn.1001-0939.2020.0007

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Abstract：Infection with 2019 Novel Coronavirus (2019-nCoV) is mainly transmitted by respiratory droplets, airborne transmission and direct contact. However, conducting bronchoscopy on patients with 2019-nCoV is a high-risk procedure in which health care workers are directly exposed to the virus, and the protection and operation procedures need to be strictly regulated. According to the characteristics of bronchoscopy, it is necessary to formulate the procedure, requirements and precautions when conducting bronchoscopy in the current epidemic situation. Relevant standards for preventing from infections should be strictly implemented in the operation of bronchoscopy. It needs to emphasize that bronchoscopy should not be used as a routine means for the diagnosis of 2019-nCoV infection sampling. The indications for bronchoscopy for other diseases should be strictly mastered, and it is suggested that bronchoscopy should be postponed for those patients who is not in urgent situation. 2019新型冠状病毒（2019 novel coronavirus，2019-nCoV）感染感染主要通过呼吸道飞沫传播、空气传播及接触传播，结合支气管镜操作的特点，制订了当前疫情下支气管镜诊疗操作的流程、要求及注意事项。进行支气管镜诊疗操作时须严格执行传染病防控相关标准，强调了支气管镜检查不作为诊断新冠感染采样的常规手段，在按要求做好防护的基础上，严格掌握支气管镜诊疗适应证，如非病情急需，建议暂缓检查。.

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DOI：10.3760/cma.j.issn.1001-0939.2020.0006

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Abstract：Corona virus disease 2019 (COVID-19) is mainly transmitted by respiratory droplets and close contact. Pulmonary function testing procedures have been associated with an increasing risk of COVID-19 transmission among patients/subjects and medical staffs. Effective prevention and control strategies must be compulsorily implemented to prevent nosocomial infection. This recommendation is intended to be followed by healthcare workers (HCWs) of pulmonary function testing laboratory when COVID-19 is in epidemic. Based on the features of pulmonary function testing, precaution principles and strategies are developed in three aspects of management for HCWs, operating procedure, environment and equipment. Indications of pulmonary function testing should be followed strictly. It is strongly recommended to suspend the test for the confirmed or suspected cases of COVID-19 during the contagious stage, and to postpone the test for other patients if it is not imperative. Medical personnel should mandatorily adhere to the standard stratification of precaution measures. Patients/Subjects should be isolated in a separate area for testing. Disposable in-line filters must be used during pulmonary function testing. Cleaning and disinfection procedures for environment and equipment in pulmonary function testing laboratory should be paid more attention. 新型冠状病毒肺炎（COVID-19）主要通过呼吸道飞沫传播及密切接触传播。肺功能检查可增加医务人员和受检者发生COVID-19传播的风险，必须严格执行有效的预防和控制措施以防止院内感染。为了指导肺功能检查室医务人员做好防控工作，本指引结合肺功能检查的特点，制订了当前疫情下肺功能检查在医务人员管理、检查流程管理和检查环境物品管理3个方面的要求及注意事项。主要强调在疫情流行期间，必须严格掌握肺功能检查的适应证，强烈建议COVID-19确诊病例或疑似病例在传染期内暂缓检查，其他病患如非病情急需也暂缓检查；肺功能室医务人员应严格执行标准分级防护措施；受试者应在单独区域进行隔离检查；检查时必须使用一次性呼吸过滤器；并重视肺功能检查环境和设备的清洁消毒。.

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DOI：10.3760/cma.j.cn112147-20200225-00175