OBJECTIVE To study characteristics of hospital infection and bacterial resistance in our neurosurgery ward to make us reasonable antibiotics use and supply the scientific basis for hospital infection control.METHODS The data of 1100 inpatients in our neurosurgery ward in 2007 were analyzed prospectively and retrospectively.RESULTS The hospital infection rate was 11.91%,the case-time infection rate 12.55%,the lower respiratory tract infection rate 69.57%,the G-infection rate 54.44%,the G+ infection rate 30%,and the fungus infection rate was 15.56%,These pathogens were resistant to antibiotics in various degree.CONCLUSIONS It is significant to continuously monitor hospital infection and bacterial resistance in our neurosurgery ward to guide reasonable antibiotics use and control hospital infection effectively.

OBJECTIVE To investigate which method for endoscope sterilization more convenient,qualified and with effectively elongating lifetime of endoscope usage.METHODS We used low temperature plasma hydroxide peroxide sterliization and 2% glutaraldehyde solution to sterilize endoscope and compared their effects.RESULTS Two methods were qualified for the requirements of serilization.Endoscope sterilization time with glutaraldehyde solution and low temperature plasma hydroxide peroxide was 10h and 55min,respectively.Sterilization-related endoscope attrition rate was 0.17% and 0,respectively,and showed significant difference(P

OBJECTIVE To find out the hand hygiene compliance among medical staff of our hospital,and discuss how to reduce the hospital infection.METHODS The questionnaires designed by ourself were used to observe the hand hygiene compliance on the scene and the hand hygiene knowledge among 120 Medical persons from 30 clinical departments and offices.RESULTS 81.7% Of the medical staff had accepted the education of the hand hygiene knowledge;89.2% of the medical staff considered washing hands could reduce the hospital infection.Only 2.5% of them considered hand hygiene had no relation to clinical treating result.30.8% Of medical staff washed their hands before contacting patients and 49.2% of them washed their hands after contacting patients.It showed significant difference between the two groups(P

Objective To evaluate the diagnostic value of high frequency ultrasound in sebaceous gland carcinoma of eyelid (SC).Methods The ultrasonic characteristic for 11 cases with eyelid SC were respectively analyzed by using 13 MHz high frequency ultrasound and 22 MHz ultra-high frequency ultrasound.Results Through 13 MHz high frequency ultrasound,in 7 patients who exhibited Pagetoid invasion the lid shin thickness of tumor side displays no significant alteration in a comparison with normal side.Furthermore,the color Doppler flow imaging (CDFI) evealed a branch-like blood flow surrounding the masses in all cases,but the blood flow of seven patients with Pagetoid invasion had no difference compared with the healthy side.On 22 MHz ultra-high frequency ultrasound examination,slit-like low echo was found in 9 ;transition zone of tumor infiltration can be identified in 9 ; the echo of tumors with Pagetoid invasion was lower than the healthy side and the skin thickness of tumors with Pagetoid invasion was thicker (0.6 ±0.1) mm than the healthy side.CDFI revealed that mesh-basket like blood flow was rich in all patients,the small branch blood vessels arrived at subcutaneous,and vasa vasorum were found in some patients.The region with Pagetoid invasion was rich in blood flow.The sonography findings on 13 MHz and 22 MHz high frequency ultrasound examination were compared with chisquare test.There were significant differences on homogeneous echo,slit-like low echo,transition zone of tumor infiltration,infiltration skin thickness,blood distribution,central blood vessels,vasa vasorum,blood flow in the region with Pagetoid invasion (x2 =12.571,15.231,15.231,4.701,22.000,15.231,4.899,10.267,P＜0.05).Conclusions Slit-like low echo in the mass is a main finding of eyelid sebaceous gland cercinoma on the 22 MHz ultra-high frequency ultrasound.The ultra-high frequency ultrasound can accurately reveal the skin depth infiltrated by the eyelid sebaceous gland cercinoma and this method can provide solid guidance for clinical treatment strategies.

OBJECTIVE To investigate risk factors of bloodstream infection in ICU.METHODS From May 2007 to Aug 2007,the operation of central venous catheter and the medical attendance of 24 cases with bloodstream infection were retrospectively analyzed.RESULTS Fifteen cases with infection(62.5%) were found in 7 days;ESBLs-producing Klebsiella pneumoniae,Enterobacter,and Acinetobacter baumannii were the major pathogens.The major risk factors included severe underlying diseases,endovascular catheter operation and incorrect asepsis barrier.CONCLUSIONS The patients are severe in ICU.In order to control and prevent infection in ICU,effective measures should be taken,including taking strict aseptic treatment in central venous catheter and the medical attendance of catheters,and strengthen hygiene administration.

OBJECTIVE To investigate the causes of fever and risk factors in portal hypertensive patients after combined operation(devascularization+shunt).METHODS Forty five cases of portal hypertension(PHT) after combined operation were retrospectively and prospectively analyzed.RESULTS Complications caused 88% post operational fever.The most common cause was hydrothorax,hematocele or hydrops and infection in splenic recess.Long-term fever was related to liver function(P

Objective To clarify the role of pentraxin 3 (PTX3) in the development of peripheral arterial disease (PAD) in maintenance hemodialysis (MHD) patients. Methods One hundred and sixteen patients undergone MHD therapy in our center for more than 3 months were enrolled in the study. Clinical data were collected for analysis. Ankle-brachial index (ABI) was used to estimate the presence of PAD. Patients were divided into PAD group (ABI<0.9) and nonestimate the association of PAD with PTX3 as well as other potential risk factors. Results The incidence of PAD was 18.1% (21/116). Plasma level of PTX3 was significantly higher in PAD patients than that in non-PAD patients [(5.55 ±2.63) μg/L vs (2.32 ±1.29)μg/L, P<0.01].Univariate analysis showed ABI values were negatively correlated with plasma PTX3 levels (r =-0.548, P<0.01), high-sensitivity C-reactive protein (hsCRP), age, blood glucose and triglyceride. ROC curve of PAD revealed that area under curve (AUC) of PTX3 was 0.901 (P<0.01). With the cut-off value of PTX3 as 4.06 μg/L, the diagnostic sensitivity and specificity in PAD were 81.0% and 91.5%. ROC curve of PAD showed that AUC of hsCRP was 0.640 (P<0.05). With the cut-off value of hsCRP as 3.33 mg/L, the diagnostic sensitivity and specificity in PAD were 57.1% and 56.8%. Using Logistic regression, plasma PTX3 was found to be associated with PAD (0R=9.755, 95%CI:2.359-19.354, P=0.001). Conclusions The PAD incidence of MHD patients in our center is 18.1%. Plasma PTX3 level is significantly correlated with the presence of PAD in MHD patients. The sensitivity and specificity of PTX3 are higher than those of hsCRP for PAD diagnosis.

Objective:To summarize and evaluate the best evidence for nonpharmacological interventions in patients with post-stroke depression.Methods:Based on the "6S" pyramid model of evidence resources, the Chinese and English databases and websites of relevant professional associations were systematically searched for evidence on nonpharmacological interventions in patients with post-stroke depression, including guidelines, evidence summaries, systematic reviews, and expert consensus. The retrieval time limit was from the establishment of the database to July 31, 2021. The quality of the article was independently evaluated by two researchers, and evidence was extracted and summarized for the article that met the quality standards.Results:A total of 15 articles were included, including 4 guidelines, 1 evidence summary, 9 systematic reviews, and 1 expert consensus. A total of 25 pieces of the best evidence were compiled from five aspects, namely, health education, exercise intervention, psychological intervention, physical intervention and traditional Chinese medicine techniques.Conclusions:Medical and nursing staff should formulate nonpharmacological interventions for post-stroke depression patients according to the specific clinical conditions and patient characteristics, and apply the evidence in clinical practice.

Objective To analyze the influencing factors of frailty in elderly patients with lower extremity osteoarthritis,and to construct and validate the risk assessment model.Methods Convenient sampling method was used to select 535 elderly patients with lower extremity osteoarthritis from tertiary hospitals and community health service centers in Hangzhou from January to September 2022 as the survey subjects including 357 in the modeling group and 178 in the validation group.Univariate and multivariate logistic regression analysis were used to determine the risk factors of frailty,construct a risk assessment model and draw a nomogram.The discrimination and calibration of the model were evaluated by the area under the receiver operating characteristic curve and the Hosmer-Lemeshow test.The Bootstrap method was used for intemal validation of the model,and the time verification method was used for external validation.Results The model variables included the number of affected joints,age-adjusted Charlson comorbidity index,pain,nutritional status,sedentary time,activity of daily living,osteoarthritis index,lower limb muscle strength,and Social Support Rating Scale score.The Hosmer-Lemeshow test results of the model showed that P=0.202,the area under the receiver operating characteristic curve was 0.942,the optimal critical value was 0.392,the sensitivity was 0.914,the specificity was 0.893,and the accuracy rate was 0.902.The internal and external validation showed that the C-statistics were 0.935 and 0.919,respectively,and the calibration curve showed good fitting.Conclusion The risk assessment model has a good degree of discrimination and calibration,which can more intuitively and easily screen elderly patients with lower extremity osteoarthritis at high risk of frailty,and provide references for early monitoring,identification,prevention and control.