Objective To explore the establishment of evaluation index system of healthcare-associated infection (HAI) control in stomatological medicine.Methods The evaluation index framework based on theme framework approach was pre-liminarily formed,Delphi method and analytic hierarchy process (AHP)were used to construct grading evaluation index, judgement matrix was adopted to calculate the weight coefficient of index.Results The qualitative and quantitative com-bined evaluation system,a three-level evaluation index system with 47 indicators,was built,which was composed of six fol-lowing dimensions:organization management,diagnosis and treatment environment,isolation measures,disinfection area, disinfectant medical devices and hygiene products,and medical waste.Among the tertiary indexes,complete documents of disinfectant medical devices and hygiene products (0.0362),object surface cleaning and disinfection(0.0344),medical waste classification and collection (0.0326),supervision and management(0.0323),flushing and disinfection of dental unit water lines (0.0321)were of higher weight coefficients.Conclusion The preliminarily established evaluation index system can provide a scientific basis and practical tool for carrying out evaluation and supervision,formulating standards,as well as developing curriculum content for HAI control in stomatological medicine.

ObjectiveTo investigate the effects of minimally invasive key-hole drainage for treating acute subdural hematoma.MethodsThirty-five patients with acute subdural hematoma treated by key-hole drainage were retrospectively analyzed.CT-oriented key-hole drainage was performed to aspirate,liquefy and drain hematoma.The transfixion pin was removed after hematoma was basically cleared within 1 to 3 days.ResultsHematoma volume decrease was greater than 80％ by follow-up CT 24 hours postoperatively.Headache and vomiting in the preoperative conscious patients were significantly relieved after key-hole drainage.Glasgow Outcome Score (GOS) was 5 points in 16 patients,4 points in 15 and 3 points in four six months postoperatively.One patient was complicated with hydrocephalus and two with epilepsy.ConclusionsKey-hole drainage with disposable transfixion pin selective employed for patients with acute subdural hematoma is effective and has few complications.The treatment notably improves prognosis of the patients.

Background: and Purpose Despite administration of evidence-based therapies, residual risk of stroke recurrence persists. This study aimed to evaluate the residual risk of recurrent stroke in acute ischemic stroke or transient ischemic attack (TIA) with adherence to guideline-based secondary stroke prevention and identify the risk factors of the residual risk. Methods: Patients with acute ischemic stroke or TIA within 7 hours were enrolled from 169 hospitals in Third China National Stroke Registry (CNSR-III) in China. Adherence to guideline-based secondary stroke prevention was defined as persistently receiving all of the five secondary prevention medications (antithrombotic, antidiabetic and antihypertensive agents, statin and anticoagulants) during hospitalization, at discharge, at 3, 6, and 12 months if eligible. The primary outcome was a new stroke at 12 months. Results: Among 9,022 included patients (median age 63.0 years and 31.7% female), 3,146 (34.9%) were identified as adherence to guideline-based secondary prevention. Of all, 864 (9.6%) patients had recurrent stroke at 12 months, and the residual risk in patients with adherence to guidelinebased secondary prevention was 8.3%. Compared with those without adherence, patients with adherence to guideline-based secondary prevention had lower rate of recurrent stroke (hazard ratio, 0.85; 95% confidence interval, 0.74 to 0.99; P=0.04) at 12 months. Female, history of stroke, interleukin-6 ≥5.63 ng/L, and relevant intracranial artery stenosis were independent risk factors of the residual risk. Conclusions There was still a substantial residual risk of 12-month recurrent stroke even in patients with persistent adherence to guideline-based secondary stroke prevention. Future research should focus on efforts to reduce the residual risk.