ObjectiveTo investigate the complications after intracranial neurosurgery in the postanesthesia care unit (PACU). Methods2166 patients enrolled into PACU after intracranial neurosurgery were reviewed. ResultsAmong the complications, the most frequent ones were hypertension (14.0%), arrhythmia (13.9%), pain (13.7%), shivering (10.5%), nausea and vomiting (9.3%), and delirium (8.6%). The least ones were hypoxemia (3.4%), respiratory obstruction (1.9%), delayed recovery (1.5%), and hypotention (0.5%). Abnormal temperature and residual block occurred at 7.2% and 22.8% in the patients who were monitored. All complications were treated immediately, and all the patients transferred to neurosurgical ward with modified Aldrete score over 9～10. ConclusionThe patient in PACU need well management to insure safe and smooth recovery from anesthesia after intracranial surgery.

Objective To evaluate the consistence in the detection of antibodies against HIV-1 between a new rapid test using oral mucosal transudate (OMT) samples and ELISA using serum samples. Methods Two-hundred patients who were positive for anti-HIV-1 antibodies by serum ELISA and confirmed by Western blot to be infected with HIV, and 600 healthy human controls negative for anti-HIV-1 antibodies by serum ELISA, were eligible for this study. OMT samples were collected from these subjects and subjected to a rapid test for anti-HIV-1 antibodies. The factors influencing the performance of the rapid test were analyzed. Results Of the 200 OMT specimens from HIV-infected patients, 198 showed positive reaction, 2 showed negative reaction. Among the 198 positive reactions, 192 (96%) were "clear" and easy to make decisions, 4 (2%) were "faint", 2(1%) were "very faint" and required professionals to make decisions. The rapid test was negative in all the 600 OMT specimens from the control group. Conclusions The consistence in the detection of anti-HIV-1 antibodies between the OMT rapid test and serum ELISA was 99% in HIV-positive specimens, 100% in HIV-negative specimens, and 99.75% in all the specimens.

Objective To investigate the acid α glucosidase(GAA)gene mutations and clinical features of a Chinese patient exhibiting signs and symptoms of infantile glycogen storage disease type Ⅱ(GSD Ⅱ). Methods Clinical features of the patient were reviewed,and GAA activity in the patient＇s and her parents＇ whole leukocytes were measured. GAA coding regions were amplified by polymerase chain reaction(PCR),and analyzed by direct DNA sequencing. Results The patient showed feeding difficulties,generalized hypotonia and weakness starting at 2 months of age. Cardiomegaly and cardiomyopathy were found at 4 months. She died of cardiorespiratory failure at the age of 6 months. GAA activity in leukocytes was low in the patient(17.3% of the median normal range). Genotyping revealed the patient was a heterozygote for a novel nonsense mutation p.W738X and a previously reported nonsense mutation p.E888X. The reported pseudodeficiency allele c.1726G ＞ A;2065G ＞ Awas found in the patient and her mother. Conclusions Correct diagnosis was made for this patient by combination of GAA activity assay and genetic analysis. From the clinical course,this patient should be classified as infantile type of GSD Ⅱ,suggesting that the novel mutation p.W738X may have a damaging effect on the function of GAA. Pseudodeficiency allele found in this family highlights the importance of genetic analysis of GAA when performing diagnosis and prenatal diagnosis for the affected families,as this allele causes low GAA activity in normal individuals.

Patient satisfaction is an important index of hospital quality evaluation and performance evaluation.This study established multi-attribute patient satisfaction index system based on the theory of customer satisfaction index,determined the index weight by combination weighting approach,and graded the hospitals and adjusted the weights by the RSR method.A set of comprehensive evaluation scheme is initially formed,which is suitable for patient satisfaction evaluation and performance evaluation.

Objective Examination and evaluation of employee satisfaction index in the hospital performance evaluation.Methods Stratified sampling,field survey and telephone survey were used in customizing a questionnaire for two surveys in July and December 201 5 respectively.Results The standardized score of employee satisfaction was 86.252±1 5.1 53,and the lowest score was found in the canteen environment and food quality.Conclusion Employee satisfaction is found as good overall,and targeted measures are recommended to improve insufficiencies for better employee satisfaction.

Objective To investigate the characteristics of Clostridioides difficile infection(CDI)in patients hospitalized for diarrhea and analyze the risk factors for CDI.Methods Stool samples were collected from 306 patients with diarrhea hospitalized in 3 university hospitals in a mid-south city of China from October to December,2020.C.difficile was isolated by anaerobic culture,and qRT-PCR was used to detect the expressions of toxin A(tcdA)and B(tcdB)genes and the binary toxin genes(cdtA and cdtB).Multilocus sequence typing(MLST)was performed for the isolated strains without contaminating strains as confirmed by 16S rDNA sequencing.Etest strips were used to determine the drug resistance profiles of the isolated strains,and the risk factors of CDI in the patients were analyzed.Results CDI was detected in 25(8.17%)out of the 306 patients.All the patients tested positive for tcdA and tcdB but negative for the binary toxin genes.Seven noncontaminated C.difficile strains with 5 ST types were isolated,including 3 ST54 strains and one strain of ST129,ST98,ST53,and ST631 types each,all belonging to clade 1 and sensitive to metronidazole and vancomycin.Hospitalization within the past 6 months(OR=3.675;95%CI:1.405-9.612),use of PPIs(OR=7.107;95%CI:2.575-19.613),antibiotics for≥1 week(OR=7.306;95%CI:2.274-23.472),non-steroidal anti-inflammatory drugs(OR=4.754;95%CI:1.504-15.031)in the past month,and gastrointestinal disorders(OR=5.050;95%CI:1.826-13.968)were all risk factors for CDI in the patients hospitalized for diarrhea.Conclusion The CDI rate remains low in the hospitalized patients with diarrhea in the investigated hospitals,but early precaution measures are recommended when exposure to the risk factors is reported to reduce the risk of CDI in the hospitalized patients.

Objective To investigate the characteristics of Clostridioides difficile infection(CDI)in patients hospitalized for diarrhea and analyze the risk factors for CDI.Methods Stool samples were collected from 306 patients with diarrhea hospitalized in 3 university hospitals in a mid-south city of China from October to December,2020.C.difficile was isolated by anaerobic culture,and qRT-PCR was used to detect the expressions of toxin A(tcdA)and B(tcdB)genes and the binary toxin genes(cdtA and cdtB).Multilocus sequence typing(MLST)was performed for the isolated strains without contaminating strains as confirmed by 16S rDNA sequencing.Etest strips were used to determine the drug resistance profiles of the isolated strains,and the risk factors of CDI in the patients were analyzed.Results CDI was detected in 25(8.17%)out of the 306 patients.All the patients tested positive for tcdA and tcdB but negative for the binary toxin genes.Seven noncontaminated C.difficile strains with 5 ST types were isolated,including 3 ST54 strains and one strain of ST129,ST98,ST53,and ST631 types each,all belonging to clade 1 and sensitive to metronidazole and vancomycin.Hospitalization within the past 6 months(OR=3.675;95%CI:1.405-9.612),use of PPIs(OR=7.107;95%CI:2.575-19.613),antibiotics for≥1 week(OR=7.306;95%CI:2.274-23.472),non-steroidal anti-inflammatory drugs(OR=4.754;95%CI:1.504-15.031)in the past month,and gastrointestinal disorders(OR=5.050;95%CI:1.826-13.968)were all risk factors for CDI in the patients hospitalized for diarrhea.Conclusion The CDI rate remains low in the hospitalized patients with diarrhea in the investigated hospitals,but early precaution measures are recommended when exposure to the risk factors is reported to reduce the risk of CDI in the hospitalized patients.

Objective:To investigate the prevalence of work-related musculoskeletal disorders among nurses in ClassⅢ Grade A stomatology hospitals.Methods:Using the convenient sampling method, a cross-sectional survey was conducted on general information, prevalence of work-related musculoskeletal disorders and working factors of 496 front-line nurses from two ClassⅢ Grade A stomatology hospitals in Beijing from November 14 to 27, 2019 by using the revised electronic version of Nordic Musculoskeletal Disorders Questionnaire revised based on the Chinese population.Results:A total of 496 questionnaires were collected and 483 were valid. The annual prevalence rate of work-related musculoskeletal disorders among dental nurses was 68.3% (330/483) . Among the 9 body parts, the top 4 affected parts were neck, shoulder, lower back and upper back. Education level was an independent risk factor for work-related musculoskeletal disorders ( P<0.01) , while physical exercise was a protective factor ( P<0.05) . Conclusions:The incidence of work-related musculoskeletal disorders among dental nurses is not optimistic.It is necessary to screen high-risk groups as soon as possible, encourage nurses to strengthen physical exercise and carry out key interventions for neck, shoulder and back musculoskeletal diseases to avoid irreversible decline in musculoskeletal function, which may affect the physical health and career development of dental nurses.

Objective:To build a sensitive quality index system of dental clinic nursing.Methods:Based on the Donabedian "structure-process-results" three-dimensional quality model, the indicators at all levels of the sensitive quality index system of dental clinic nursing was preliminarily constructed through literature review. The Delphi method was used to develop a system of sensitive quality indicators for dental outpatient care through two rounds of correspondence with 15 experts from the fields of dental care management, oral health care, quality of care management, and health policy.Results:The effective response rates of the two rounds of expert inquiry questionnaires were 100% (15/15), and the average authority coefficient of the experts was 0.93. The Kendall's harmony coefficients of the overall indicators were 0.115 and 0.141, respectively ( P<0.05). A sensitive quality indicator system for dental clinic nursing was finally determined, including 3 primary indicators, 7 secondary indicators and 19 tertiary indicators. Conclusions:The sensitive quality indicator system for dental clinic nursing constructed in this research is scientific and reliable. After verification through future research, it can serve as a basis for improving the quality of dental clinic nursing.

Objective To explore the construct validity of the competency assessment questionnaire for junior registered nurses and offer evidence for further tool developments. Methods A total of 603 junior registered nurses from eight level three class A hospitals in Beijing were included and investigated by the competency assessment questionnaire. Exploratory factor analysis was used to analyze the data. According to the results and the experts panel discussion, the items were selected and adjusted. Results The final questionnaire consisted of 4 factors with 23 items and the accumulating explanatory rate of the 4 factors was 61. 785%. The Cronbach′s α coefficient was 0. 787. Conclusions The competency assessment questionnaire for junior registered nurses can evaluate the competency of nurses from 4 aspects, and can also help to guide the improvement of following standardized training.