OBJECTIVE To discuss cause and nursing of hospital infection in infectious disease ward.METHODS Hospital infection in infectious disease ward of a general hospital was analyzed retrospectively.RESULTS The hospital infection rate was 6.18%;the main site of infection was respiratory tract(48.84%);November is the highest month of infection rate.The infection rate was seen higher among liver disease patients.CONCLUSIONS The hard ware must be enhanced to reform and the sickroom arrangement be regularized.It is important for hospitals to strengthen infection control.The main treatment to control hospital infection is applying aseptic operation strictly.

Objective To investigate the clinical value of dynamic glucose monitoring in the middle and late pregnant women with diabetes mellitus,and the related clinical and nursing measures.Methods One hundred admitting cases of the middle and late pregnant women with diabetes mellitus were grouped according to the random number table,50 cases of the control group were treated with finger tip blood glucose monitoring and conventional treatment,50 cases of dynamic blood glucose monitoring and comprehensive clinical and nursing intervention for the observation group.The blood glucose control situation with different time,the incidence of hypoglycemia,the actual control range of the glycosylated hemoglobinblood and the length of hospital stay and so on were evaluated in two groups.Results The incidence of hypoglycemia in the observation group was 6.0％ (3/50),the control group was 24.0％ (12/50),the difference was statistically significant (P ＜ 0.05).In the early morning,after breakfast 2 h,before and after lunch 2 h,before and after dinner 2 h and before bed and other different time,the blood glucose level with the observation group was lower than that in the control group (P ＜ 0.05).At the same time,in the blood glucose effective controlling time,hospitalization time,the observation group was better than the control group (P ＜ 0.05).The blood glucose level and the detection range of the glycosylated hemoglobin were also detected in the safe state for outpatient follow-up after hospital discharge.Conclusions The intervention of dynamic blood glucose monitoring and comprehensive clinical and nursing measures in middle and late pregnant women with diabetes mellitus is conducive to control blood glucose level timely and accurately and to improve their prognosis.It is the key to the success of the future obstetric prevention and diagnosis and treatment of the disease,and is recommended clinical popularization.

Objective: To analyze and to predict the 1 year re-admission risk in patients of chronic heart failure with reduced left ventricular ejection fraction (HFrEF) by echocardiography.
Methods: A total of 313 HFrEF patients in our hospital community from 2007-01 to 2008-12 were studied. The patients were followed-up for (6-7) years and the end point was 1 year re-admission. All patients received routine echocardiography and the parameters included left ventricular ejection fraction of (LVEF), left ventricular diameter (LVd), pulmonary artery systolic pressure (PASP), mitral regurgitation (MR), tricuspid regurgitation (TR) and pericardial effusion. Based on the above 6 parameters, the risk factors for 1 year re-admission were analyzed.
Results: Univariate analysis indicated that MR (HR=1.437, 95%CI 1.190-1.737, P=0.000), TR (HR=1.288, 95%CI 1.056-1.572, P=0.013) and pericardial effusion (HR=1.560, 95%CI 1.050-2.318, P=0.028) had better predictive value for 1 year re-admission. Multivariate analysis presented that MR (HR=1.404, 95%CI 1.159-1.701, P=0.001) took ifrst place for predicting the 1 year re-admission and pericardial effusion took second place (HR=1.410, 95%CI 1.030-1.928, P=0.032).
Conclusion: MR, TR and pericardial effusion were the independent predictors for 1 year readmission in HFrEF patients;while MR and pericardial effusion were the independent risk factors for 1 year re-admission.

OBJECTIVE:To compare the economics of interferon α1b and α2b in the treatment of chronic hepatitis C. METH-ODS:By retrospective study,114 patients with chronic hepatitis C who received interferon were selected,60 patients received interfer-on α1b were divided into group A and 54 patients received interferon α2b were divided into group B. Negative conversion rate of HCV-RNA,normalization rate of ALT and the incidence of ADR in 2 groups were compared,and pharmacoeconomic analysis was conducted. RESULTS:Negative conversion rates of HCV-RNA in group A in 4,12,24,36,48 weeks were 55.00%,71.67%, 63.33%,61.67% and 65.00%,group B were 64.81%,66.67%,62.96%,55.56% and 61.11%,respectively,there were no signifi-cant differences between 2 groups (P>0.05);after treatment,normalization rate of ALT in group A was 95.23%,group B was 96.10%,there was no significant difference between 2 groups(P>0.05);and there were no significant differences in the incidence of ADR between 2 groups (P>0.05),so cost-minimization analysis was used to evaluate pharmacoeconomics. Therapy cost in group A was 13 216.56 yuan,group B was 7 929.60 yuan,group B was lower to group A;sensitivity analysis received the same results. CON-CLUSIONS:Interferonα2b is more economical thanα1b in the treatment of chronic hepatitis C.

Objective: To assess blood levels of renal function related influencing factors with baseline clinical parameters for predicting the risk of 8-year survival in patients with chronic heart failure (CHF). Methods: A total of 293 CHF patients admitted in our hospital from 2006-07 to 2009-11 were enrolled. The patients were followed-up until 2014-6-30, the end point was death. According to followed-up results, they were divided into 2 groups: Survival group,n=107 and Death group,n=186. All patients received routine renal function and electrolytes examination including blood levels of urea nitrogen, creatinine, uric acid, sodium, potassium, chloride, calcium, anion gap and phosphorus; GFR was calculated by MDRD formula. Baseline clinical parameters as left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) were measured by echocardiography; blood pressure (BP) and heart rate (HR) were recorded. The risk factors for 8-year survival in CHF patients were analyzed. Results: Compared with Survival group, Death group had increased LVEDD, urea nitrogen, creatinine and uric acid, while decreased LVEF, HR, GFR, blood sodium and calcium, allP<0.05. Univariate analysis indicated that LVEDD, LVEF, GFR, urea nitrogen, creatinine, uric acid, blood sodium, calcium and phosphorus had the better predictive value for the risk of 8-year survival in CHF patients, allP<0.05. Multivariate analysis presented that LVEDD, GFR and blood sodium had the highest predictive value for the risk of 8-year survival, allP<0.001; the next one was blood calcium,P<0.01. Conclusion: LVEDD, GFR, blood sodium and calcium were the independent predictors for the risk of 8-year survival in CHF patients.

Objective To evaluate the right ventricular function of chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary thromboendarterectomy (PTE) by Doppler echocardiography. Methods In 16 patients with CTEPH,end-diastolic left ventricular diameter(LVDd), end-diastolic right ventricular areas (RVEDA), end-systolic right ventricular areas (RVESA), right ventricular fractional area change (RVFAC), pulmonary accelerative time (Pact), pressure gradient of tricuspid valve regurgitation (PGT1), area of tricuspid valve regurgitation (AT1) were measured by echocardiography. Results Fifteen and thirty days after surgery,the LVDd and Pact had increased,RVEDA, RVESA,PGT1 and AT1 had decreased while RVFAC had increased in all cases. Conclusions PTE may effectively improve the right ventricular function of patients with CTEPH.

Vitiligo is an acquired depigmented disease, and neurological factors may play an important role in its pathogenesis. Neurogenic inflammatory factors released by sensory nerves that control the skin can directly or indirectly regulate functions of keratinocytes, melanocytes, Langerhans cells, dermal dendritic cells, mast cells, dermal microvascular endothelial cells and immune cells. This review summarizes roles of several relevant neurogenic inflammatory factors in the occurrence and development of vitiligo, including neuropeptide Y, calcitonin gene-related peptide, catecholamines and nerve growth factor, with a view to providing new ideas for clinical treatment of vitiligo.

To know the status of nursing training about physical restraint among nurses in the domestic and overseas. Summarized the forms, content and the appraise tools of the results of physical restraint nursing at home and abroad so as to provide reference of nursing training about the physical restraint among nurses in the domestic.

OBJECTIVE:To investigate the omeprazole off-label use and provide reference for rational drug use in clinic. METHODS:In retrospective survey,1838 omeprazole prescriptions were selected from outpatient department during Jun. 2014 to May 2017 by random number table. According to the latest drug instruction,whether the off-label use or not was determined. Off-label use was determined by reviewing domestic and foreign guidelines,literatures and Micromedex database. RESULTS:Among 1838 pre-scriptions,there were 1750 prescriptions of off-label drug use (95.21％),involving 13 items and 3 types of off-label drug use. Main type of off-label drug use was over-indication medication,involving 1747 prescriptions (96.47％). There was no statistical significance in the incidence of off-label drug use between digestive department and non-digestive department or among physicians at different levels(P>0.05). Among 13 items of off-label drug use,7 items were supported by evidence-based medicine evidence of domestic and foreign guideline,expert consensus/suggestion or literature reports,etc.;among which 1 item of off-label drug use were included in Micromedex grading system and other 6 items had no evidence-based medicine evidence. CONCLUSIONS:The phenomenon of omeprazole off-label use is widespread in outpatient department of the hospital,and some off-label drug use are sup-ported by evidences. There are differences in the quality of those evidences. It is suggested to standardize the off-label drug use to avoid legal risks and guarantee the safety of drug use for patients.

The study developed a metabolic balance model to evaluated the cardiotoxicity of doxorubicin. The rats were divided into 3 groups, control group(saline), low dose group(8 mg/kg of cumulative doxorubicin)and high dose group(15 mg/kg of cumulative doxorubicin). Doxorubicin or saline was intraperitoneally injected and blood sample was collected at day 1, 4, 7 and 10. The concentrations of nitric oxide(NO), B-type natriuretic peptide(BNP)and the activity of glutathion peroxidase(GSH-Px), xanthine oxidase(XOD)in rat plasma were determined. A metabolic balance model based on the four biomarkers was developed to evaluate the doxorubicin cardiotoxicity in rat. Doxorubicin leaded to significant changes of multiple biomarkers, resulting in metabolic balance disruption according to the metabolic balance maps and dynamic parameters of metabolic balance disruption. Moreover, the correlation study showed a good relationship between metabolic balance disruption and ejection fraction(EF). The metabolic balance model provide a novel method to integrally evaluate the doxorubicin-induced cardiotoxicity.