Objective To realize the current status of central sterile supply departments(CSSDs)in hospitals,and provide the basis for making improvement measures.Methods Field investigation was adopted to study the resource distribution,personnel structure,and the quality of medical instrument cleaning in 78 hospitals in Chongqing.Re-sults Qualified results of 78 hospitals was 24.36% (19/78),basically qualified rate 52.56% (41/78),unqualified rate 23.08% (18/78);inspection results of different types of hospitals were significantly different(Hc= 16.643,P=0.002),qualified hospitals mainly concentrated on city- and county-level hospitals.Unqualified rate of CSSD con-struction area was 78.21% (n= 61),unqualified rate of personal allocation was 75.64% (n= 59),concentrated man-agement of operating rooms and CSSDs was 52.56% (n= 41),mainly concentrated on city- and county-level hospi-tals;decentralized management accounted for 47.44% (n= 37),58(74.36% )hospitals used repeated cleaning stain-less steel tables for receiving,50% didn’t install automated cleaning machine and drying cabinet,42.31% (33/78) performed manual cleaning,40(51.28% )didn’t equip with water treatment system;12(15.38% )hospitals used patched or worn clothing for packing,47 didn’t equip with hard metal container,37(47.44% )had no heat sealing machine,21(26.92% )had no detection equipment for cleaning quality,41(52.56% )had no low temperature sterili-zation instruments;52(66.67% )hospitals performed biological monitoring on high pressure steam sterilizer.Conclu-sion Clean and disinfection equipments in CSSDs in city- and county-level hospitals are well-appointed,procedures of clean and disinfection are standard,and can achieve the standard of clean quality;while hospitals affiliated to fac-tories and private hospitals are not well-appointed,procedures of clean and disinfection are not standard. Construc-tion of CSSD should be standard,so as to ensure the effectiveness of clean,disinfection and sterilization of surgical instruments.

Monitoring data of antibiotic susceptibility from both home and abroad showed that carbapenem-resistant Enterobacteriaceae (CRE) are being on the rise,which represents an increasingly urgent clinical danger and an emerging public health concern worldwide.In order to effectively prevent CRE transmission in healthcare settings,we should not only pay high attention to the capability building of the laboratory of clinical microbiology,but also actively explore into the mechanisms of carbapenem resistance in Enterobacteriaceae.What's more,we should substantially raise the detection capacity of laboratory on CRE,effectively carry out the antimicrobial stewardship program,and strictly implement hand hygiene and contact precautions.(Chin J Lab Med,2013,36:300-302)

Objective To investigate the epidemiological characteristics and clinical features of mumps.Methods The epidemiological characteristics,clinical manifestations and treatment of 198 cases with mumps were retrospectively analyzed.Results The onset age of mumps was less than 15 years old,men more than women,the crowd distribution was mainly the students,especially in winter,spring and summer.The clinical characteristics were as following:corresponding parotid gland enlargement occurred at the onset of mumps,some of the patients may be accompany by fever,nausea,vomiting,chest tightness,palpitation,or had the performance of the headache,dizziness,muscle weakness,sleepiness and nervous system complications.The results of laboratory tests showed that white blood cell(WBC) of most patients was in the normal range; blood,urine amylase obviously increased; a few cases with abnormal myocardial enzyme spectrum and liver function.Chest X-ray and electrocardiogram(ECG) were normal.4 cases had EEG abnormality.All cases received ribavirin antiviral treatment,and were given corresponding symptomatic treatment to the complications,all patients recovered.Conclusion Epidemiological characteristics were local epidemic,obvious seasonal difference,the student was the main body.Common complications were encephalitis,gland inflammation,myocarditis,hepatitis,etc.,mumps vaccine should be advocated in the students.

In the treatment of human epidermal growth factor receptor 2 (Her-2) overexpressing breast cancer,some patients have drug resistance to trastuzumab.Potential mechanisms of resistance to trastuzumab include impaired access of trastuzumab to Her-2 ; alternative signaling from insulin-like growth factor-1 receptor (IGF-1R),hepatocyte growth factor receptor (HGFR) and so on; aberrant downstream signaling caused by loss of phosphatase and tensin homologs deleted from chromosome 10 (PTEN);phosphatidylinositol 3-kinase catalytic alpha polypeptide gene (PIK3CA) mutation; over-expression of heat shock protein 90 (HSP90) and CD44. Additionally,potential strategies for overcoming resistance to trastuzumab include using new targeted medicines,such as pertuzumab,lapatinib and trastuzumab-DM1.

Acupuncture Therapy ; Aged ; Female ; Humans ; Middle Aged ; Olfaction Disorders ; etiology ; physiopathology ; therapy ; Sinusitis ; complications ; Smell

Dizziness ; classification ; epidemiology ; Humans ; Vertigo ; classification ; epidemiology

Congresses as Topic ; Humans ; Milk Banks ; Milk, Human ; North America

Objective To survey the clinical application of glycopeptide antibiotics in hospitalized patients, and evaluate the rationality of drug use, so as to provide reference for rational clinical drug use.Methods A retrospective study was conducted to investigate the application of glycopeptide antibiotics among inpatients in a hospital from January to December in 2014, relevant clinical data were recorded.Results A total of 727 cases were included , 471 (64.79%) of which were infected cases.Respiratory tract infection was the main site of both healthcare-associated infection and community-associated infection (39.17% and 45.98%, respectively).The average days of glycopeptide antibiotic use were 6.06 day (4 403/727).Patients who used glycopeptide antibiotics were mainly from intensive care unit, department of oncology, and department of neurosurgery, accounting for 20.36%(n=148) , 12.10%(n=88), and 11.14%(n=81) respectively.Glycopeptide was used in 338 patients(46.49%),the average types of combined use was 4.43, triple and above was used in 99 patients(13.62%),combination of the second generation cephalosporins was the highest(20.48%).450(61.90%) patients used vancomycin, 260(35.76%)used teicoplanin,17(2.34%)used both vancomycin and teicoplanin.A total of 847 pathogenic strains were isolated, the major were Acinetobacter baumannii (n=111, 13.10%), Klebsiella pneumoniae (n=80, 9.45%), Pseudomonas aeruginosa (n=68, 8.03%), and Staphylococcus aureus (n=54 , 6.37%), methicillin-resistant Staphylococcus aureus was 50 strains.490 (67.40%) patients treated with glycopeptide antibiotics were effective.Of 727 patients, 86 (11.83%) used antibiotics rationally, 315(43.33%) basically rational,and 326 (44.84%) irrationally.Conclusion Application of glycopeptide antibiotics in this hospital is basically rational, but indications should be paid attention.

BACKGROUND:Bionic structure is one of the most important goals of scaffold design in tissue engineering. However, the majority of the bionic scaffolds do not have the capacity of sustained release of growth factors.
OBJECTIVE:To fabricate a novel biomimetic nanofibrous heparin/gelatin scaffold and investigate the characterization of the scaffolds including the microstructure, the mechanical strength andin vitro recombinant human bone morphogenetic protein-2 (rhBMP-2) release.
METHODS:Heparin-conjugated gelatin was prepared by chemical crosslinking and mixed with gelatin at different ratios. Nanofibrous composite scaffolds with different ratios of heparin-conjugated gelatin (0, 20% and 40%) were fabricated by using a thermaly induced phase separation combined with particle leaching technique. The amount of conjugated heparin in the scaffolds, scaffold microstructures and mechanical strength were detected and observed. The release kinetics of rhBMP-2 from the scaffolds with different concentrations of heparin conjugated gelatin was detected using ELISA method.
RESULTS AND CONCLUSION:The composite scaffolds possessed abundant porosities, good mechanical properties, and biomimetic nano-structures. The macroporous size was 250-420 μm. When the ratio of heparin-conjugated gelatin was 0, 20% and 40%, the content of heparin in the scaffolds was 0, (12.82±2.49) and (25.08±3.69) mg/g, respectively, with significant differences; the elastic modulus of the composite scaffolds was (299±38), (286±40) and (236±33) kPa, respectively, with insignificant differences (P > 0.05). With the increase in the content of heparin-conjugated gelatin, the rhBMP-2 adsorption capacity of the nanofibrous heparin/gelatin scaffold is improved, thereby significantly reducing the burst release of rhBMP-2 and prolonging the releasing time.

Objective To investigate and analyze the residents′knowledge and satisfaction on basic public health services in five districts of Gansu ,to judge the implementation effect of the current policy ,in order to provide the suggestion to improve the effect of the implementation of the policy of basic public health services .Methods Based on typical sampling method ,1 688 rural and urban residents had been investigated coming from five counties in Gansu by using questionnaires to survey .Results The de‐gree of residents′knowledge about the policy was low (57 .23% );the residents could know about the policy through a variety of ways ,and mainly for medical staff to promote by approaching their homes ;91 .94% of surveyed residents thought that policy service was more convenient when they were accepting ;90 .99% of surveyed residents thought that they satisfied with the service attitude of staff ;82 .35% of surveyed residents believed that the policy service effects was obvious ;90 .11% of surveyed residents overall satisfied with the service of policy .The above results were different in proportion in various counties(P<0 .05) .Conclusion The degree of residents′knowledge and satisfaction on basic public health services in five districts of Gansu still needs to be improved .