Objective To evaluate the clinical efficacy of Jianpi pill in the treatment of leucocytopenia induced by anti -thyroid drug.Methods According to the digital table,195 Graves hyperthyroidism patients with leucocytopenia induced by anti -thyroid drug were randomly divided into the observation group(100 cases)and the control group(95 cases).The observation group was given Jianpi pill treatment,while the control group adopted the combination therapy of batilol tablets,leucogen tablets,vitamin B4 tablets.The facial color,whether or not limb weak-ness,whether or not palpitations after strenuous exercise in the two groups were observed.The number of white blood cells and the number of neutrophils in the two groups were observed.3 months later,the curative effect of the two groups was determined according to the degree of cure.Results The total effective rates of the control group and the observation group were 52.63% and 85.00% respectively,the difference was statistically significant between the two groups(χ2 =23.96,P <0.01 ).The disappear infection rates of the control group and the observation group were 25.00% and 69.05% respectively,the difference was statistically significant between the two groups (χ2 =15.93, P <0.01 ).The total effective rates of mild,moderate,severe leucocytopenia were 95.56%,87.50%,46.67%respectively,the difference was statistically significant between mild and severe leucocytopenia (χ2 =16.00,P <0.01),and the difference was statistically significant between moderate and severe leucocytopenia(χ2 =7.94,P <0.01).The excellence rates of mild,moderate,severe leucocytopenia were 48.89%,40.00% and 48.89% respec-tively,the difference was statistically significant between mild and severe leucocytopenia(χ2 =5.92,P <0.01),and the difference was not statistically significant between moderate and severe leucocytopenia(χ2 =2.41,P >0.05).The incidence rates of dry mouth,hyperactive bowel sounds and liver damage,constipation and diarrhea in the control group were 4.21%,2.10% and 1.05% respectively,and the incidence rates of dry mouth,hyperactive bowel sounds and liver damage in the observation group were 3.00% and 1.00% respectively,there was no significant difference in adverse reactions between the two groups(P >0.05).Conclusion The curative effect of Jianpi pill in the treatment of Graves hyperthyroidism patients with leucocytopenia induced by anti -thyroid drug is sure,and it is superior to the combination therapy of batilol tablets,leucogen tablets,vitamin B4 tablets.

Objective To evaluate the therapeutic efficacy of YunKe and prednisone on moderate and severe thyroid associated ophthalmopathy(TAO).Methods 1 08 hyperthyroidism patients with moderately severe TAO were randomly divided into YunKe group,hormone group and the control group.All of the patients were given anti -thyroid medication(ATD)treatment.By thyroid hormone level upper limit every times higher than normal for a sulfhydryl imidazole 5mg/day to calculate daily dosage,based on thyroid hormone level adjusted a sulfhydryl imidazole dose every two weeks,make thyroid hormone levels in the normal range.YunKe set:intravenous push note YunKe per day A +B agent four groups (including cloud 20mg),each treatment medicine for five days in A row,interval of 25 days to the next period of treatment,medication six procedures.Hormone group:oral prednisone for 6 months,monthly dose in the order 1 mg·kg -1 ·d -1 ,0.75mg·kg -1 ·d -1 ,0.5mg·kg -1 ·d -1 ,0.25mg·kg -1 ·d -1 ,0.1 25mg·kg -1 ·d -1 , 0.062 5mg·kg -1 ·d -1 ,1 time a day,took at 8 o'clock in the morning.The control group treated ATD.Before and 6 months after treatment,all of the patients were checked the TNF -αand TRab,CT scan to measure degree of exophthalmus.Six months after treatment,respectively,on the basis of TAO classification (NOSPECS)and TNF -α, TRab level changes to determine the efficacy of treatment.Data entry Excel 2003 statistical software,used SPSS 1 9.0 statistical software to analyze data.Non parametric tests of three groups of data with Kruskal Wallis test.Not matching the two independent samples nonparametric test with the Mann -Whitney test,with P <0.05 for the difference was statistically significant.Results The markedly effective rate,effective rate and ineffective rate of YunKe group were 36.1 %,47.2% and 1 6.7% respectively,which of the hormone group were 20.0%,37.1 % and 42.9%,which of the control group were 1 3.9%,22.2% and 63.9%.The efficacy among the three groups had statistically significant differences (Kruskal -Wallis χ2 =1 0.736,P =0.005 ).The lighter exophthalmos,tge curative effect was better (Mann -Whitney Z =-4.599,P <0.001 ).The changes of TNF alpha,TRab levels among the three groups had significant differences(YunKe group,the TNF alpha,TRab levels markedly reduced 75.0% and 80.6%,respectively, which of the hormone group were 37.1 % and 34.3%,which of the control group were 1 9.4% and 27.8%,TNF χ2 =23.527,P <0.001 ;TRab χ2 =23.831 ,P <0.001 ).Conclusion The therapeutic efficacy of YunKeon TAO is better than prednisone,but the long -term effect deserves more investigation.

Objective On the background of the clinical skills competition for national medi-cal students in the higher medical colleges and universities, to investigate medical students' mastery of hand hygiene knowledge and skills, explore the effective methods of teaching, and improve the medical students' hand hygiene compliance and accuracy in clinical practice. Methods 90 medical students at a tertiary-level teaching hospital clinical practice stage were randomly selected for the study, and performed hand hygiene theoretical knowledge and practical skills training in special education. Special teaching investigation was made before and after training, to investigate the students' hand hygiene compliance rate in clinical practice. And the correct rate of hand hygiene were examined and medical students' hand hygiene compliance rate and correct rate were compared before and after the special teaching and training. Statistical analysis was made by using chi square test 2. Results After theory teaching and additional special skills training the students' hand hygiene compliance and accuracy were improved significantly (79.00%vs. 35.50%, P=0.000). The correct rate of hand hygiene was also significantly higher than before training (92.22% vs. 61.11%, P=0.000). Conclusion Hand hygiene knowledge and skills training can significantly improve the medical students' hand hygiene compliance and accuracy in the clinical practice, and is conducive to the prevention of the spread of infection in hospitals, and then reduce the incidence of hospital infection.

Purpose To explore the association between ultrasound contrast agent injection volume as well as regurgitation and tubal patency. Methods SonoVue contrast agent was used for 515 cases of infertility transvaginal four-dimensional ultrasound imaging hysterosalpingography, recorded the amount of contrast agent injection, regurgitation, and compared contrast agent injection volume and regurgitation in different patency. Results The ultrasound contrast agent injection volume between bilateral patency with bilateral passable and one side patency one side passable as well as one side patency one side barrier, between one side patency one side passable and one side patency one side barrier had no significant difference (U=1467.0-4843.0, P>0.05);and it had statistical difference between any other two conditions (U=273.5-6160.0, P<0.05). The regurgitation between bilateral passable and bilateral barrier, one side passable one side barrier, between bilateral barrier and one side patency one side barrier, one side passable one side barrier, between one side patency one side passable and one side patency one side barrier had no statistical difference (U=949.5-6378.5, P>0.05), and it had statistical difference between any other two conditions (U=919.5-5126.5, P<0.05). Conclusion Ultrasound contrast agent injection volume and regurgitation in hysterosalpingography are associated with tubal patency, which can be used as objective indexes for assessing tubal patency, and provide basis for tubal patency.

Routine supervision on hospital infection control was normally fed back on paper-based media,plagued by low efficiency and poor traceability.A feedback process developed with Workflow technology,can loop the entire process ranging from routine supervision to identifying loopholes,to hospital infection and joint development of correctional measures clinically,all the way to implementation of infection control practice and sustained improvement.The closed-loop PDCA cycle management features greater efficiency and traceability in hospital management of its infection control,and builds a quality improvement model featuring close communication between infection control department and clinical departments.

OBJECTIVE To investigate the pertinency between acute physiology and chronic health evaluation Ⅱ scores(APACHEⅡ)and nosocomial infection.METHODS The clinical data from 1 007 ICU patients were evaluated with APACHEⅡ scores system,and made a prospective survey of nosocomial infection.RESULTS Along with the increase in APACHEⅡ scores,nosocomial infection rate and mortality showed rising trend and they were in linear relationship.CONCLUSIONS APACHEⅡ scores system not only can appraise the degrees of severity of illness,evaluate medical treatment,and estimate the prognosis,but also forecast nosocomial infection.

OBJECTIVE To focus on the diagnosis,treatment and prevention of central venous catheter(CVC)-related bloodstream infections(CRBSI)in clinical practice.METHODS The related articles within the nearest 10 years were reviewed,which published in the domestiec and foreign academic journals,at the same time,the related monitoring data of the hospital were analyzed.RESULTS Highlights on the diagnosis,treatment and prevention of CRBSI:for the patients with CVC,the possibility of the CRBSI should be considered,as soon as a high fever was found,and it could not be explained with the non-infectious causes.Infection occurring time and pathogen were different between the general catheters and the anti-infective catheters.The effect of the anti-infective catheters was limited.To pull out the catheters was one of the most effective treatment measures.CONCLUSIONS Prevention of CRBSI:the indications of CVC intubation should be undisputed.Silicone catheter should be used.When the catheter is predicted to be indwelling more than 5 days,anti-infective catheters should be chosen.To insert CVC at the subclavian vein instead of the femoral vein.To care the hub and keep the puncture point dry and do disinfection well.The health care workers should be trained.

OBJECTIVE To evaluate the risk factors of nosocomial infection(NI),then establish the evaluation system for risk factors of NI in ICU.METHODS A total of 1897 ICU patients were enrolled in our study.The risk factors of NI were classified and quantified,then investigated the relativity of the risk factors and NI.RESULTS NI correlated with APACHEⅡscore,serum prealbumin level,blood products uese,incision of trachea,mechanical ventilation,central vein cannula and enteral nutrition.CONCLUSIONS The risk factors of NI evaluatied in ICU can to be used to lay the foundation for the model of NI early warning.

OBJECTIVE To study the risk factors of hospital acquired urinary system infection in neurology ICU(NICU) and emergency ICU(EICU).METHODS The general character,score of APACHE Ⅱ and the time length of urethral catheterization of the 502 NICU and EICU patients were enrolled in our study.Then the relativity of the risk factors and hospital acquired urinary system infection were investigated.RESULTS Urethral catheterization increased the chances of hospital acquired urinary system infection and there were more chances with the long time.CONCLUSIONS In order to decrease the rate of hospital acquired urinary system infection we must strictly grasp the indication of urethral catheterization and pull out the urethral catheter as early as possible.

OBJECTIVE To study relativity of systemic inflammatory response syndrome(SIRS) score and nosocomial infection(NI) and outcome in ICU patients.METHODS A total of 1897 ICU patients were enrolled in our study.The SIRS within 48 hours after admission was recorded.And the prospective evaluation in NI and prognosis was made.RESULTS The nosocomial infection rate was 10.1%,and the mortality was 9.9%.With SIRS score increasing,NI and mortality rates increased as well and the tendency presented a linear correlation.CONCLUSIONS As a simple system,SIRS score can initially predict the risk of NI and outcome in ICU patients.