Objective To carry out patients' participation in promoting health care workers(HCWs) to improve hand hygiene (HH) compliance in the outpatient transfusion room, obtain real data of HH, and further provide basis for performing the activity in the whole hospital.Methods HH compliance of nurses in outpatient transfusion room during four stages was observed by using the healthcare-associated infection control toolkit mobile phone APP.Intervention was not implemented at the first stage, HH promotion was implemented at the second stage, simulation of patients participated in promoting HCWs to improve HH compliance was performed at the third stage, and patients actually participated in promoting HCWs to improve HH compliance at the fourth stage.A questionnaire about patients' willingness to participate in the promotion of HCWs to improve HH compliance was developed and filled out by patients and nurses.Results HH compliance rates of nurses in transfusion room at four stages were 21.43%, 44.27%, 61.48%, and 82.88% respectively, differences was significant(χ2=110.35,P<0.01);HH correct rates at four stages were 44.44%, 74.14%, 81.33%, and 81.82% respectively, differences was significant(χ2=18.50,P<0.01).Conclusion Patients participating in promotion of HH can significantly improve HH compliance of HCWs, which is simple and effective, and worth to be popularized.

Objective To investigate the prevalence rates of healthcare-associated infection(HAI)and antimicrobial use in a maternal and child health hospital,so as to provide reference for preventing and controlling HAI.Methods A cross-sec-tional survey on HAI prevalence of all hospitalized patients from 2010 to 2014 was conducted by combination of bedside ex-amination and medical record review.Results The prevalence rates of HAI in 2010—2014 was 3.29%,5.20%,3.97%, 3.93% and 3.73% respectively.HAI mainly occurred in patients at department of pediatrics (9.09%-12.96%),the major infection site was upper respiratory tract (50.00%-69.56%).Antimicrobial usage rate was 50.19%,41.40%, 23.40%,25.47% and 23.92% respectively,which decreased year by year (χ2 = 133.40,P <0.001 );antimicrobial prophylactic usage rate was as high as 57.38%-75.47%;single usage rate were all>95%.Conclusion Antimicrobial a-gents used by hospitalized patients showed a overall downward trend from 2010 to 2014.,but antimicrobial prophylactic us-age rate is high,management of antimicrobial agents should be strengthened.

Angioplasty, Balloon, Coronary ; Humans ; Percutaneous Coronary Intervention ; methods ; Tungsten

Some ideas were proposed on establishing the mobile medical information service system by relying on the communication platforms such as Wechat , microblog and hospital website , in order to provide mobile informa-tion service for medical staff .The functions of its information need access module , information source module and information transfer module were described in detail, and certain suggestions were put forward for its normal opera-tion, such as active popularization, attraction of its user groups, development of information service file database, establishment of incentive mechanisms , and construction of information service team.

Objective To pool the data of studies and evaluate the efficacy and safety of TNFα blocking agents in the treatment of ulcerative colitis(UC).Methods The randomized clinical trials(RCT)that compared the efficacy or safety of TNFα in the treatment of UC were researched from Pubmed. OVID. EMBASE. Cochrane library, CNKI, Wanfang data and VIP Chinese Scientific and Technologic Periodical Database. Statistical heterogeneity between trials was evaluated by Revman 5.0 and was considered to exist when P＜0.1.Heterogeneity of the included articles was tested. which was used to select proper effect model to calculate. Publication bias was investigated through visual inspection of funnel plots. Results Nine RCT including 1226 cases were analyzed. Eight hundred and six cases had received TNFα treatment and 420cases had received placebo or glucocorticoid treatment. Compared with placebo or glucocorticoid groups, TNFα group achieved significantly higher rates of short-term clinical response, short-term clinical remission, long-term clinical response.10ng-term clinical remission and the total OR were 2.36(95%C,1.34-4.15),2.42(95%CI 1.22-4.81).3.22(95%CI2.28-4.55)and 2.82(95%CI1.91-4.16)respectively. TNFα group was less likely to undergo colectomy than placebo group and the total OR was 0.31(95%CI0.20-0.48).TNFα could not improve the mucosal healing and quality of lire. No significant difference was found in adverse effect between TNFα group and placebo or glueoeortieoid group(OR=1.07(95%CI0.55-2.09,P=0.84)).The rate of serious adverse effect in TNFα group was less than placebo or glueoeorticoid groups (OR=0.65,95%CI0.48-0.89,P=0.007).Inspection of the funnel plots for all dichotomous data measures had not revealed evidence of publication bias. Conclusions Patients with moderately to severely active UC treated with TNFαhave effective clinical response and clinical remission and are less likely to undergo colectomy than those receiving placebo or glucocorticoid. TNFα treatment is safe for UC but can not improve the mucosal healing and quality of life. Large-scale, high-quality RCTs ale needed to confirm or refuse the available evidence.

Objective To evaluate the level situation of clinical doctors graduating from mil-itary medical university within a certain period, understand their career development, and explore and analyze the problems and deficiencies in doctoral education and training to provide reference for deep-ening the reform of clinical disciplines doctoral education. Methods Stratified random samples of 9 Hospitals were selected and the established evaluation index system of clinical discipline quality tracking and investigation questionnaire was used to evaluate doctoral quality. Evaluation was surveyed by self rating and other rating combination. Quality evaluation system contains 4 first level indicators such as the military and political quality, clinical, teaching and research level, the development po-tential as well as 15 second-level indexes. The scores of self-assessment and other evaluation were compared by Pearson rank correlation analysis. The corresponding indicator scores of different doctorate types were compared using the test of variance and the subject research and published papers were analyzed by χ2 inspection. Results The comprehensive score of graduated doctors is excellent, with self-evaluation score (92.72±7.06) and other evaluation score (93.61±8.05). Correlation coefficient is 0.33(P=0.04); The academic doctors have done better in publishing papers(χ2=5.97, P=0.01) and undertaking subject research(χ2=6.08, P=0.00), but poorer in clinical work compared with the doctors of professional degree. The assessed groups are inadequate in publishing high level papers and in un-dertaking research projects and doctors of different degree types have different cognition of the ele-ments of improving the quality. Conclusions Cultivating the doctors' clinical ability and innovation ability are the cores of deepening the reform of clinical doctoral education. We should focus on inno-vation ability , value the cultivation of the clinical professional doctoral degree and explore various joint evaluation systems to attain the goal of enhancing the education quality of doctors.

Objective To evaluate the effects of different interventions on and influencing factors of picky eaters aged 1 to 5 years old.Methods Two hundred and forty-seven individuals were randomly assigned to the Identification and Management of Feeding Difficulties (IMFeD) group (n =147) and the control group (n =100).The IMFeD group received comprehensive guidance once a month,3 times in total;while the control group had traditional eating guidance.Scores of the IMFeD group were compared with the control group.Multivariate method was used for data analysis.Results Behavior scores of the IMFeD group were 4.7 ± 1.1 at baseline and 9.5 ± 2.6 after the intervention ; although behavior scores of the control group were 4.9 ± 1.1 at baseline and 6.6 ± 2.3 following the routine guidance (F =32.99,P ＜ 0.001).Univariate analysis showed that those two interventions significantly affected the outcomes of intervention (x2 =52.76,P ＜0.05).Regression analyses revealed an odds ratio (OR) of 6.171 (95％ confidence interval (CI) 3.652-10.428) or 0.448 (95％ CI:0.264-0.761) for intervention strategy and time with parents during their 1 year.Conclusion Family-based periodicity intervention may play an important role in eating behavior change and should be widely conducted in child health care.

Objective To investigate the prevalence of Hepatitis B virus(HBV)infection in systemic lupus erythematosus (SLE)patients.Methods HBV and HCV serological tests performed in the Gulou Hospital Affiliated to Medical College of Nanjing University from January 2010 to March 2015 were retrospectively investigated for analysis HBV and HCV infection rate.The clinical testing data of 866 SLE inpatients (SLE group)from January 2010 to March 2015 were retrospectively in-vestigated for analysis HBV and HCV infection rate.The serological tests performed in 1 795 health examination people (Control group)to estimate the HBV and HCV infection ratein general population using ELISA.Compare the difference of HBV/HCV infection rate between SLE group and Control group.Results In the SLE group,17 patients were HBsAg posi-tive,the positive rate was 1.96%.In the control group HBsAg postive 204 patients,the positive rate was 11.4%,there were significant differences between these two groups (χ2 =67.81,P <0.0001).The HBsAg positive rate was lower in male SLE patients compared with controls (5.26% VS 13.9%,χ2 =4.58,P <0.05).For the female SLE patients,the HBsAg positive rate was significantly lower than the control (1.64% VS 8.12%,χ2 = 35.65,P <0.0001).The HBsAg positive rate was lower in SLE group compared with control group among different age groups,and the difference was significant in 21~30, 31~40 and 41~50 age group (χ2 =21.86,22.78,20.36;all P <0.001).There had no statistical difference between SLE and control group for the HBsAb positive rate(Total,χ2 =0.50,P =0.48;Male,χ2 =0.12,P =0.73;Female,χ2 =2.00,P =0.16).Conclusion The prevalence of HBV infection in SLE patients was lower than general population.

Colorectal cancer is one of common gastrointestinal malignant diseases,with a rising incidence in our country.Human gut is colonized by intestinal flora which impacts host nutrient and energy metabolism,immune function.And there is an emerging concept that intestinal flora also plays an important role in the pathogenesis of colorectal cancer.In this paper,the role of intestinal flora in the pathogenesis of colorectal cancer and possible mechanisms were reviewed.

Objective To explore the effect and safety of rituximab (RTX) in children with frequently relapsed nephrotic syndrome.Methods Twelve children (8 male and 4 female) with frequently relapse nephrotic syndrome were treated with RTX.They all showed resistance to various immunosuppressive agents and relapsed when steroid was reduced at 1.5-2.0 mg/kg.All immunosuppressive agents were stopped.Steroid was prescribed at doses of 2 mg/(kg · d),followed by alternate-day dosing (2 mg/kg) after proteinuria was negative for 5 days,and then tapered by 5 mg every 2 weeks until to low dose (＜ 0.5 mg/kg on alternate day) or discontinued.RTX was administered at a dose of 375 mg/m2 once every week for 3 weeks.Results The patients were followed up for 4-19 months [median (7.79 ± 3.00) months].Proteinuria turned negative on 1-14 d after first RTX treatment.Mean steroid dosages were significantly reduced than before treatment [alternate-day dosing (1.83 ± 1.02) mg/kg vs alternate-day dosing (0.34 ± 0.16) mg/kg,t =3.78,P =0.002].Gingival hyperplasia and Cushing appearance were significantly improved and steroid-induced glaucoma disappeared.The height was significantly increased compared with before treatment [(2.21 ± 1.40) cm/year vs (8.27 ±2.10) cm/year].Six cases had no relapse during follow-up.Another 6 cases relapsed in 5.5-19.0 months.All patients showed CD19 + B lymphocytes depletion after RTX treatment.However,CD19 + recovery could be seen in 5.5-12.0 months.Serum immunoglobulin did not significantly change.None of the patients was found with adverse events.Conclusions RTX can significantly reduce the dosage of steroid or even stop medication in children free of immunosuppressive agents,maintain remission for (7.79 ± 3.00) months,significantly improve the adverse reaction induced by steroid and immune-suppression.Thus,for children with frequently relapsed nephritic syndrome/steroid-dependent nephrotic syndrome who show resistance to immunosuppressive therapies,RTX treatment may be considered.