OBJECTIVE To discuss the risk factors and countermeasures of hospital infection in department of laboratory. METHODS The risk factors existing in department of laboratory for hospital infection were imestigated and corresponding measures and strategies were set up. RESULTS By adopting corresponding measures and strategies, hospital infection in department of laboratory was controlled and prevented. CONCLUSIONS The occurrence of hospital infection in the department of laboratory can be effectively prevented, through the establishment of complete system, strict operation of the rules and corresponding control measures.

Objective To profile the types of bacteria in bile culture and study their antibiotic sensitivity pattern in patients with varying de-grees of acute cholangitis and to provide data guidance for the prevention and treatment of bacterial infection.Methods The clinical data of 230 patients with acute cholangitis who were admitted to our hospital from April 2010 to April 2014 were retrospectively analyzed.Classifica-tion of pathogenic bacteria and the antibiotic sensitivity test in bile cultures were performed using VITEK 2 Compact Biomerieux microbiologi-cal system.Results Within the 230 patients,172 tested positive for biliary bacteria,and the positive rate was 74.78%(172/230).There were 237 strains of pathogenic bacteria,including 135 strains of Gram-positive bacteria (56.96%),comprised mainly of Enterococcus and Staphylococcus aureus,96 strains of Gram-negative bacteria (40.5 1%),comprised mainly of Pseudomonas aeruginosa,Escherichia coli, and Klebsiella pneumonia,and 6 strains of fungi (2.53%),comprised mainly of yeast.Significant difference in the positive rate of bacteria was detected between patients with mild and severe cholangitis (χ2 =4.58,P =0.028).Gram-negative bacteria were the predominant i-solates in patients with mild and moderate acute cholangitis,while multiple bacterial infection was more common in patients with severe cholangitis.Biliary bacteria had a higher rate of susceptibility to vancomycin,imipenem,and amikacin compared with other antibiotics. Conclusion Gram-positive bacteria are the predominant pathogens in acute cholangitis.Early detection,immediate intervention,and ac-curate drug susceptibility test should be implemented at regular intervals to direct effective clinical therapy.

Objective Early identification of deep vein thrombosis(DVT) risk in patients with joint arthroplasty helps to reduce the incidence of DVT.The study aimed to investigate the effectiveness of Autar risk assessment model in assessing DVT risk in patients with joint arthroplasty.Methods 72 patients with DVT from 10 hospitals from November 2014 to February 2016 were selected as the case group, and 144 non-DVP patients who hospitalized during the same period served as the control group.The medical history, laboratory tests and other related clinical data of the patients were collected, and Autar risk assessment scale was used to evaluate the patients.Multiple logistic regression was applied to analyze the relationship between the risk scale of DVT and the risk of DVT formation.Results 216 patients were included in the research.The Autar score of DVT patients (17.09±2.83) in case group was higher than that of control group (14.25±2.46) and the difference is of statistical significance(P<0.05).The area under the ROC curve of Autar scale in case group was 0.789 (95％CI: 0.719, 0.858,P<0.05).When the ROC curve cutoff point was 15, the sensitivity and the specificity of Autar scale were 88.57％ and 57.90％ respectively.In Autar scale, the main risk factors of DVT incidence were age≥70 years old, BMI≥30, strict bed rest, varicose veins, lower limb injuries and orthopedic surgery.The result of logistic regression analysis showed the difference of Autar risk rating between these two groups was of statistical significance(P<0.05).In comparison with low risk group, the DVT risk of patients with joint arthroplasty at medium risk was of no significant difference (OR=1.178, 95％ CI: 0.733-1.490, P=0.053) while that of patients with joint arthroplasty at high risk was of significant difference (OR=5.536, 95％ CI:3.577-7.132, P<0.001).Conclusion Autar DVT risk assessment scale assessed patients with joint arthroplasty at high risk are high risk group of DVT.The risk of DVT increases with the risk rating in patients with joint arthroplasty.Therefore, Autar risk assessment scale can be applied in the assessment of DVT risk in patients with joint arthroplasty.

Objective To compare the clinical characteristics and therapeutic differences between the Chinese and American patients with Crohn′s disease. Methods 85 patients in the Chinese PLA General Hospital (301 Hospital) and 68 patients in the Cleveland Clinic Florida (CCF), USA with Crohn′s disease from 1985 to 2004 were studied retrospectively. The statistic data were analyzed with Chi-square tests. Results The ratio of male and female patients in 301 Hospital was 1.74∶1 and in CCF was 1∶1.43. The incidence of positive family history and extra intestinal manifestations in CCF were higher than in 301 Hospital (P

Objective To investigate the effects of splenectomy on peripheral immune cells including Th17 cells in patients with portal hy-pertension and to analyze the influence of splenectomy on their immune function.Methods Twenty-five portal hypertension patients trea-ted with splenectomy in No.180 Hospital of PLA from June 2012 to June 2014 were selected as observation group,and 25 healthy controls who underwent physical examination in the same period as control group.Flow cytometry was used to determine the percentages of CD3 , CD4,and CD8 T lymphocytes,CD4/CD8 ratio,and percentage of Th17 cells in the peripheral blood of portal hypertension patients (1 day before operation and at 7 days,1 month,and 3 months after operation)and healthy controls.ELISA was used to evaluate the changes in ser-um interleukin-6 (IL-6),interleukin-17 (IL-17),and interleukin-23 (IL-23).Comparison between groups was made by one-way ANOVA and LSD-t test.Results Before splenectomy,the portal hypertension patients had significantly lower percentages of CD3, CD4,and CD8 T lymphocytes and CD4/CD8 ratio (P<0.01 for all)and significantly higher percentage of Th17 cells and levels of their as-sociated inflammatory cytokines (IL-6,IL-17,and IL-23)(P<0.01 for all),as compared with the control group.At 7 days,1 month,and 3 months after operation,the percentages of CD3,CD4,and CD8 T cells and CD4/CD8 ratio in portal hypertension patients first decreased and then increased,and these values were significantly lower at 7 days after operation than before operation (P<0.01 for all);at 3 months after operation,the patients showed no significant differences in the percentages of CD3,CD4,and CD8 T cells and CD4/CD8 ra-tio compared with the control group (P>0.05 for all).At 7 days,1 month,and 3 months after operation,the percentage of Th17 cells and levels of their associated inflammatory cytokines (IL-6,IL-17,and IL-23)in portal hypertension patients decreased gradually (P<0.05 for all).Conclusion Th17 cells and their associated inflammatory cytokines (IL-6,IL-17,and IL-23)are reduced in portal hy-pertension patients treated with splenectomy,so their immune function can be improved.

Objective To discuss the emergency interventional therapy for ureter invasion by CACX, obstructive bilateral hydronephrosis and uremia complicated with hemorrhoea. Methods 5 cases with ureter invasion by CACX, obstructive bilateral hydronephrosis and uremia suffered from hemorrhoea during hemodialysis, who were performed with emergency interventional therapy. Results After therapy, hemostasis were realized in all cases, and all symptoms were alleviated, such as vaginal fluid and fall-swell in pelvis. The short-term total effective rate was 100% . Conclusion Interventional chemoembolization can be used in the treatment of CACX with acute hemorrhoea.

Adult ; Drug Resistance, Microbial ; Female ; Humans ; Male ; Middle Aged ; Pneumonia ; complications ; microbiology ; Silicotuberculosis ; complications ; microbiology

Objective To determine the median effective target effect-site concentration (EC50) of sufentanil when intraoperative wake-up test was successful in patients undergoing scoliosis surgery.Methods Ninety ASA Ⅰ or Ⅱ patients,aged 18-64 yr,with body mass index ＜ 30 kg/m2,scheduled for scoliosis surgery under sevoflurane and sufentanil anesthesia,were randomly divided into Ⅰ-Ⅵ groups (n =15 each).Anesthesia was induced with sufentanil,etomidate and cisatracurium,and maintained with sevoflurane,sufentanil and cisatracurium.The patients were tracheal intubated and mechanically ventilated.Before the wake-up test,infusion of cisatracurium was stopped and the end-tidal concentration of sevoflurane was adjusted to 0.The EC50 was determined by the K(a)rber method.The target effect-site concentration of sufentanil was set at 0.19 ng/ml in group Ⅰ,0.18 ng/ml in group Ⅱ and gradually decreased in decrements of 0.01 ng/ml.The wake-up test was performed 5 min later.The EC50 and 95 ％ confidence interval of sufentanil were calculated by the K(a)rber method.Results EC50 of sufentanil obtained was 0.164 ng/ml and 95％ confidence interval of sufentanil obtained was 0.157-0.172 ng/ml when the wake-up test was successful.Conclusion The EC50 of sufentanil is 0.164 ng/ml when the intraoperative wake-up test is successful in the patients undergoing scoliosis surgery.

BACKGROUND: Crohn's disease is complex and lack of specificity; meanwhile, it is related to diseased regions, areas,severity and complications in intestine. Otherwise, it is difficult to diagnose. The etiological factors are still unclear and radical therapy is lack recently. Therefore, clinical manifestations and therapeutic measures of Crohn' disease at home are different from those abroad.OBJECTIVE: To compare the clinical characteristics and therapeutic differences between the Chinese and American patients with Crohn's disease.DESIGN: Retrospective case analysis.SETTING: Department of Digestion, General Hospital of Chinese PLA.PARTICIPANTS: A total of 85 Chinese patients with Crohn's disease were selected from General Hospital (the 301 Hospital) of Chinese PLA from 1985 to 2004; meanwhile, a total of 68 American patients with Corhn's disease were selected from Cleveland Clinic Florida (CCF) from 1985 to 2004. Diagnostic criteria were based on WHO standards and all patients were diagnosed according to endoscope, X-ray manifestations and pathological characteristics.METHODS: Clinical data, including age, sex, family history, external manifestations of intestine, diseased regions and characteristics, drug treatment and surgical therapy, were compared between Chinese and American patients.Otherwise, enumeration data were compared with Chi-square test.MAIN OUTCOME MEASURES: Age, sex, family history, extra intestinal manifestations, diseased regions and characteristics, drug treatment and surgical therapy of Crohn's disease.RESULTS: ① General status and extra intestinal manifestations of intestine: The ratio of male and female patients in the 301 hospital was 1.74:1 and in CCF was 1:1.43. The incidences of positive family history and extra intestinal manifestations were 7% and 34%, which were higher in CCF than those in the 301 hospital (1%, 14%, x2=4.631 2, 8.315 0,P ＜ 0.05). ② Diseased regions and pathological characteristics: The terminal ileum was involved at most (69%) and no patients had perianal diseases in the 301 hospital and the main pathological characteristics were ulcer (66%) and obstruction (14%). Those were higher than those of patients in CCF (25%, 4%, x2=25.309 2, 4.024 6, P＜ 0.05).Compared with the 301 hospital, the patients in CCF had more pathological changes in colon and rectum and more perianal diseases and intra-abdominal fistulas were involved (51%). The incidences of perianal diseases and intra-abdominal fistulas were 51% and 9%, which were higher than those of patients in the 301 hospital (0, 6%, x2=38.429 0, 0.148 2, P ＜ 0.05). ③ Therapy: The main selections of medicine were sulfasalazine salicylazosulfapyridine (SASP, 54%), 5-aminosalicvlic acid (5-ASA, 19%) and metronidazole (21%) in 301 hospital, but in CCF, steroids (60%),azathioprine (34%) and infliximab (46%) were the main selections of medicine. Rates of surgical therapy were higher in CCF than those in the 301 hospital (96%, 49%, x2=36.145 9, P ＜ 0.01).CONCLUSION: There are significant differences in clinical characteristics and therapeutic measures between Chinese and American patients with Crohn's disease, which is one of the reasons for the two hospitals to take different treatments.

Objective To investigate the clinical curative effect of Milligan‐Morgan and Ligasure blood vessels closed system for conducting mixed hemorrhoidectomy under local anesthesia .Methods 68 inpatients with mixed hemorrhoid in the general sur‐gery department of our hospital from April 2009 to April 2012 were selected and randomly divided into the Ligasure group (observa‐tion group ,34 cases) and the Milligan‐Morgan group (control group ,34 cases) .The operation adopted the local infiltration anesthe‐sia .The postoperative followed up lasted for 6‐36 months .The operation time ,intraoperative blood loss ,total hospitalization cost , postoperative hospital stay time ,postoperative pain degree and the postoperative complications were compared between the two groups .Results The average operation time in the control group and the observation group was (32 .35 ± 10 .24)min and (20 .29 ± 7 .88) min(P=0 .000) ,the average intraoperative blood loss was (29 .71 ± 14 .67)mL and (4 .97 ± 2 .89) mL(P=0 .000) ,the aver‐age postoperative pain score was (5 .88 ± 1 .12) points and (3 .47 ± 0 .83) points(P=0 .000) ,the average postoperative hospital stay time was (7 .97 ± 2 .55) d and (2 .29 ± 1 .17) d(P=0 .000) ,and the average hospitalization expense was (1 541 .32 ± 205 .91) Yuan and (2 872 .32 ± 652 .30) Yuan ,respectively ,the differences between the two groups were statistically significant (P=0 .000) .Dur‐ing the hospitalization period and follow‐up ,the anal exudation rate and the average postoperative pain score in the control group were higher than those in the observation group(P=0 .000) ,the occurrence rate of other complications had no statistically signifi‐cant differences between the two groups .Conclusion The Ligasure operation mode has less intraoperative blood loss ,shorter opera‐tion time and shorter postoperative hospital stay time .