Objective To establish the reference intervals for thyroid-stimulating hormone(TSH) ,triiodothyronine(T3 ) ,thy-roxine(T4 ) ,free triiodothyronine(FT3 ) and free thyroxine(FT4 ) in healthy people aged between 18 and 60 years old in Haikou are-a .Methods According to the recommendations of clinical and laboratory standards institute(CLSI)C28-A3 document ,401 persons aged between 18 and 60 years old were recruited from Haikou(275 male ,126 female) .The makers were analyzed by gender .Estab-lished the reference intervals of TSH ,T3 ,T4 ,FT3 and FT4 in Haikou area .Results Reference intervals based on gender were estab-lished as TSH(0 .58-4 .60 mIU/L) ,T3 (1 .11-2 .31 nmol/L for male ,0 .97-2 .13 nmol/L for female) ,T4 (72 .24-152 .22 nmol/L ) ,FT3 (4 .17-6 .33 pmol/L for male ,3 .95-5 .47 pmol/L for female) ,FT4 (13 .16-21 .29 pmol/L for male ,12 .13-19 .61 pmol/L for female) .Conclusion This study has established the reference intervals of TSH ,T3 ,T4 ,FT3 and FT4 in healthy people aged between 18 and 60 years old in Haikou area .

OBJECTIVE To discuss the feasibility of the establishment of the ventilator management center.METHODS Through the investigation on the circumstances of the use of ventilator in 2005 to find out the risk factors of ventilator associated pneumonia(VAP).RESULTS In whole hospital-acquired infections cases,VAP occupied 54.3% in lower respiratory tract infections.CONCLUSIONS Ventilator management is an important and complex work and the establishment of a ventilator management center is a favorable measure to prevent nosocomial infections.It is not only grant the use of ventilator in emergency,but also reduces the incidence of nosocomial infections.It can raise the intact rate of ventilator use,reduce energy and human resources consumption greatly and create a good economic and social benefits.

OBJECTIVE To discuss the cause of CABG infection and its controlling methodology. METHODS In order to conduct comparative analysis of 40 cases of CABG incision infection and 40 cases of CABG without infection,the "rank sum test" statistical models were applied. RESULTS According to the analysis of statistics,the hospitalized days and costs in sample group with infection were higher than that of control group,and the difference had statistical significance.Compared with the control group,the hospitalized days of sample group with infection averagely increased 43.03 days(2.85 times),and the total hospitalized costs of it averagely increased RMB 84 314.38 yuan(2.02 times). CONCLUSIONS Apart from patients themselves,there are also many possibilities which will cause the infection,which request the on-going works on surgery skills improvement,standardizing the process of aseptic technique,disinfection and isolation,utilizing antimicrobial agents rationally,reducing patients′ hospitalized days before surgery,as well as improving the pre-operative management etc.

OBJECTIVE Discuss the cooperative relationship between The Office of Nosocomial Infection Control("the Office") and the Center for Disease Control and Prevention("the Center") in hospital.METHODS The cooperative relationship between the Office of Nosocomial Infection Control and the Center were analyzed,the third degree A Class hospitals in Beijing area.RESULTS 25 hospitals had set up Centers.Among them,there are special stuff in charge of the report of the infection in 17 hospitals which had the Office with the function of the Center.So far,none of the Offices with the function of the Center can operate all the functions of the office.CONCLUSIONS The setup of the Center is to detect and control infectious disease on the basis of nosocomial infection control.

Objective We tried to investigate the nutritional status and related factors in patients undergoing allogenetic hematopoietic stem cell transplantation.Methods A total of 75 patients were recruited from a class-three hospital in Suzhou.They were investigated with a basic information questionnaire and the Patient-Generated-Subjective Global Assessment (PG-SGA).The related factors influencing nutritional status were analyzed.Results The PAB level began to rise since conditioningregimen,and it rose to the highest level in the second week,then began to decline.The weight and the BMI had been declining in the four weeks since conditioning regimen.29.33％ of the patients were malnourished,the scored PG-SGA was (5.60±4.96),the percentage of patients with dietary problems was 33.3％ before conditioning regimen; 85.33％ of the patients were malnourished,the scored PG-SGA was (19.26±7.18),the percentage of patients with dietary problems was 93.2％ in the second week since conditioning regimen; 85.33％ of the patients were malnourished,the scored PG-SGA was (12.95±6.19),the percentage of patients with dietary problems was 75.8％ in the fourth week; Age is the main factor affecting the patients' albumin level in the second week.Conclusions The nutritional status of patients deteriorated and the percentage of patients with malnutrition increased during allogeneic hematopoietic stem cell transplantation.Clinical staff should pay attention to the assessment of nutritional status,and give a reasonable nutritional support when necessary.

Objective To understand the development history and current situation of healthcare-associated infection(HAI)management in children’s hospitals in China during the past 30 years.Methods A retrospective survey was conducted in 20 children’s hospitals,the investigated contents included:basic situation of hospitals, HAI management organizations and professionals,the support of hospital leaders for the management of HAI, training on HAI knowledge,monitoring on HAI,and so on.Results Up to 2015,20 hospitals all set up independent HAI management departments and HAI management committees,46.15%(6/13)of hospitals with more than 1 000 beds were understaffed in HAI management.There were a total of 88 professionals in HAI management in 20 children’s hospitals in 2015,53.41% (n=47)of professionals had bachelor degree,34.09% (n=30)were with intermediate professional title,46.59%(n=41)were nursing staff.Up to 2015,incidences and missing report rates of HAI,antimicrobial usage rates,incidences of HAI in neonates all decreased compared with 2006.In 2015,20 (100.00%)hospitals all carried out monitoring on antimicrobial application,multidrug-resistant organisms,disin-fection and sterilization,and provided personnel protective equipment.In 2015,9(45.00%)hospitals used non-tou-ch faucets in all wards,19(95.00%)hospitals supplied hand-drying paper towel and alcohol-based hand rub in all wards.None of professionals in these hospitals participated in national-level training on HAI for ≥3 times in 1996, professionals in 11 hospitals (55.00%)participated in national-level training for ≥3 times in 2015.Conclusion In the past 30 years,the management of HAI in children’s hospitals in China has basically met the requirement,moni-toring on HAI gradually improved,but allocation of HAI professionals and personnel quality ability still need to be strengthened.

Objective To investigate the status and influencing factors of infusion-related adverse events in third-party cord blood stem cell infusion. Methods A total of 305 patients successfully underwent haploidentical stem cell transplantation combined with the third-party cord blood(CB) infusion,were recruited by convenience sampling from January 2013 to December 2015,in hematological department of a tertiary hospital in Suzhou. A self-developed questionnaire and adverse event assessment scale were used to investigate the influencing factors. Results The rate of infusion-related adverse events was 49.51%,81.82% were related to cardiovascular adverse events with the high-est rate of hypertension(76.14%). Logistic regression analysis showed that age(OR=1.030,95CI%:1.010-1.051),HLA matching between CB and receptor (OR=0.589,95%CI:0.413-0.838),thawed CB cell activity (OR=1.064,95%CI:1.015-1.115)were major influencing factors. Conclusion Nurses should pay attention to patients who are elderly,with low matching HLA and receive thawed CB product with high cell activities,and provide timely nursing care in advance.

ObjectiveTo study the effect of negative pressure suction during laser in situ keratomileusis (LASIK) on rabbit retinal structure.Methods32 New Zealand white rabbits were randomly divided into normal control, experimental control, negative suction 45 seconds and negative suction 3 minutes groups. Experimental control groups were treated only using eximer laser. In negative suction groups, rabbit eyes were suction for 45 seconds or 3 minutes by negative pressure generator. The tissues of optic nerve and retina both after negative pressure suction and of normal rabbit eyes were examined with electron and light microscope 0, 7, 14, 28 days after operation. ResultsThere was no change in the tissues of optic nerve and retina between normal control and experimental control. After the negative pressure suction for 45 s, the optic nerve and retinal cells changed lightly at different time point. After the negative pressure suction for 3 min, the optic nerve fibers and retinal cells changed sharply during postoperative instant to 14th days, which can be recovered until 28 days after operation.ConclusionUltrastructural changes of retina and optic nerve may be induced by acute intraocular pressure elevation caused by negative pressure suction during LASIK.

Objective To explore the effects and influencing factors of traditional occupational health training on occupational health literacy (OHL) of employees in micro-, small- and medium-sized enterprises. Methods A total of 540 employees from 154 micro-, small- and medium-sized enterprises, who participated (347 employees) and not-participated (193 employees) in traditional occupational health training, and 171 community residents/students (not-participated in occupational health training) were selected as the research subjects using the convenient sampling method. The OHL level was investigated using Occupational Health Literacy Questionnaire of National Key Populations. Results The overall OHL level of employees was 43.3% (234/540). Among them, the overall OHL level of untrained and trained employees was 38.9% and 45.8%, respectively, and the overall OHL level of community residents/students was 43.3%. The results of multivariate logistic regression analysis showed that the higher the educational level, the higher the OHL level (all P<0.01). The OHL level of untrained and trained employees was higher than that of untrained community residents/students (all P<0.05). The interaction of education level and training status had no statistical difference on the OHL level of the research subjects (P>0.05). The results of factorial design analysis of variance showed that the overall OHL score rate of untrained employees and trained employees was higher than that of untrained community residents/students (all P<0.05). However, there was no significant difference in overall OHL score rate between untrained and trained employees (P>0.05). Conclusion The role of traditional occupational health training in improving the OHL level of employees in micro-, small- and medium-sized enterprises needs to be improved. The responsibility of enterprise occupational health training should be implemented, and multiple measures should be taken to enrich the ways and approaches of occupational health education for enterprise employees, to effectively improve the OHL of workers.

Objective: To evaluate the effects of CYP2C19 genetic polymorphism on the plasma concentration of voriconazole in patients with hematological disease and the value of serial monitoring plasma concentrations in the treatment and prevention of invasive fungal disease (IFD). Methods: From January 2016 to December 2016, 65 hematological patients who received voriconazole intravenous administration for the treatment of invasive fungal disease were enrolled in this study. The population CYP2C19 polymorphism of voriconazole were performed using PCR-Pyrosequencing. The trough plasma concentrations of vriconazole (C_trough) was detected by ultra performance liquid chromatography tandem mass spectrometry. Results: Based on the genotype analysis, 65 subjects were identified as extensive metabolizers’ group (30 cases) and poor metabolizers’ group (35 cases). The C_trough of the 65 patients were detected for 169 times totally, and there was a significant difference of C_trough values between the two groups [0.98(0.38-2.08) mg/L vs 2.19(1.53-4.27) mg/L, z=10.286, P<0.001]. The medium of C_trough in 65 hematological patients were described. Lack of response to therapy was more frequent in patients with voriconazole levels <1.5 mg/L (50.0%) than in those with voriconazole levels >1.5 mg/L (20.5%) (P=0.052). And the risk of adverse events was more frequent in patients with voriconazole levels >5.5 mg/L (80.0%) than in those with voriconazole levels ≤5.5 mg/L (8.3%) (χ²=11.689, P=0.020). Conclusion Patients with CYP2C19 wild-type phenotype are extensive metabolizers, their C_trough of voriconazole are significantly lower than patients with CYP2C19 non-wild-type phenotype (poor metabolizers). Appropriate concentrations of vriconazole can improve the efficacy and safety during treatment.