OBJECTIVE To prevent hospital infection in the sterilization and supply department and improve medical and nursing quality.METHODS Working steps and factors probably related to hospital infection in the sterilization and supply department were investigated,which included rinse,package,sterilization,storage and supply.RESULTS The incidence of hospital infection went down because of strictness of working steps in the sterilization and supply department.CONCLUSIONS Strictness of working steps in the sterilization and supply department can effectively decrease the incidence of hospital infection

Objective To evaluate the incidence of and risk factors for syphilis seroconversion amomg drug addicts during methadone maintenance treatment (MMT).Methods A retrospective study was performed on drug addicts receiving MMT at MMT clinics in Maanshan,who were seronegative for syphilis before the treatment and followed up by serological tests for syphilis for more than two years.The incidence of and risk factors for syphilis seroconversion during the two years of follow up were analyzed in all the subjects.Results A total of 161 drug addicts were included in this study,of whom,15 experienced seroconversion for syphilis with the average seroconversion rate being 4.66 per 100 person-years.The seroconversion tended to occurr in the early stage of MMT.Both Chi-square analysis and multivariate logistic regression analysis showed that syphilis seroconversion was independently associated with nonuse of condoms during the last sexual behavior before receiving MMT.Conclusions Interventions should be undertaken as early as possible to promote safe sexual behaviors among drug addicts at methadone clinics,and to promote condom use is especially important for blocking sexual transmission of diseases.

Objective In order to understand the children's blood lead load and presence status of blood lead levels,provide the first-hand information on further preventive intervention in high lead hyperlipidemia.Methods This study routinely collected 5 to 9-year-old children's blood,a total of 1963 cases.Peripheral blood lead levels was detected by atomic absorption spectrometry.Results Blood lead ≥ 100μg/L is 45 cases in 1963 cases of children, the rate is 2.3%, the highest is 439μg/L,only one.Other 44 persons' blood lead level is 100 ~ 200μg/L,average 149.2μg/L.Conclusion The children's blood lead levels in Beilun district of Ningbo city is in normal state in general,not high blood lead load.

[ ABSTRACT] AIM:To investigate the effects of pathological products, urinary proteins and advanced glycosyla-tion end products ( AGE) produced in the progression of chronic kidney disease ( CKD) , on the structure and function of lysosomes in renal tubular epithelial cells ( TECs ) , and try to find a novel approach for preventing or delaying CKD. METHODS:The renal specimens of the untreated patients with minimal change nephrotic syndrome (MCNS), diabetic nephropathy (DN) or normal kidney were collected.The expression of lysosomal-associated membrane protein 1 (LAMP1) and cathepsin B ( CB) was studied in TECs by indirect immunofluorescent staining.Human renal tubular epithelial cell line HK-2 was incubated with 8 g/L urinary proteins or 100 mg/L AGE.The expression of LAMP1 and CB was investigated by indirect immunofluorescence and the activity of CB and cathepsin L ( CL) was measured by biochemical and enzymatic as-says.The degradation of DQ-ovalbumin was also determined.RESULTS: The lysosomal membrane permeabilization oc-curred in the TECs of MCNS and DN patients.After treatment with urinary proteins or AGE-BSA, the lysosomal membrane permeabilization of the HK-2 cells was increased.The activity of CB and CL and degradation of DQ-ovalbumin were de-creased as compared with normal control group.CONCLUSION:The digestive function of lysosome was decreased and ly-sosomal membrane permeabilization occurred in the TECs exposed to urinary proteins and AGE, which might be a key factor to induce the tubulointerstitial fibrosis.

Objective:To investigate the self-defect sensation and its influencing factors in patients scheduled for photodynamic therapy for port wine stains.Methods:A total of 183 patients scheduled for photodynamic therapy for port wine stains in our hospital were selected and investigated by online questionnaire. The data of the respondents were collected by means of online filling in the questionnaire star using the General Data Survey Scale and the Defect Perception Scale (FIS) at admission.Results:The total score of self-defect in 183 patients with bright red nevus treated by photodynamic therapy was higher than that of the domestic norm. Age ( t=4.19), place of residence ( F=14.90), co-resident ( F=3.21), education level ( F=4.39), marital status ( F=2.47), income level ( F=9.51) and occupation ( F=5.82) had significantly related with the level of self-deficiency of patients ( P<0.05). The results of multiple linear regression analysis indicated that residence and income level were the main factors affecting patients′ sense of self-deficiency ( F=4.96, P<0.05). Conclusions:The overall self-defect sense of 183 patients with port wine stains treated with photodynamic therapy in this survey is more serious, their own comprehensive conditions and family structure will affect the self-defect sense of patients with port wine stains. We should pay special attention to the mental health of patients from municipal cities and low-income levels, timely carry out clinical nursing education and psychological guidance, jointly improve the compliance and cooperation of patients with treatment, and promote the rapid recovery of patients.

Objective:To investigate the management of patients with intravenous misplacement of nephrostomy tube following percutaneous renal surgery.Methods:The data of 6 patients with intravenous misplacement of nephrostomy tube during percutaneous nephrolithotomy (PCNL) treated in the two hospitals of Chenzhou from January 2006 to December 2020 were retrospectively analyzed. The median age was 41.0(38.5, 53.0) years old. There were 4 males and 2 females. Three patients had undergone contralateral upper urinary tract operation. One patient had undergone ipsilateral upper urinary tract operation. Two patients had not undergone upper urinary tract operation. Two of the 6 patients had a solitary kidney. Two patients were diagnosed with staghorn calculi (combined with mild hydronephrosis in 1 patient, moderate hydronephrosis in 1 patient). Four patients were diagnosed with ureteral calculus (combined with mild hydronephrosis in 2 patients, moderate hydronephrosis in 1 patient, severe hydronephrosis in 1 patient). In all 6 patients, the tract was dilated with fascial dilators. Immediately after dilator removal, brisk venous bleeding was noted. A nephrostomy tube was inserted promptly through the sheath to tamponade the tract and was immediately closed. Five cases were diagnosed by CT after operation, and 1 case was early diagnosed by intraoperative injection of contrast medium through nephrostomy tube. The nephrostomy tube was misplaced in 5 patients with left upper urinary tract calculi, and in 1 patient with right upper urinary tract calculi. The tip of nephrostomy tube was located in ipsilateral renal vein in 3 patients with left upper urinary tract calculus, inferior vena cava in 2 patients with left upper urinary tract calculus, and contralateral renal vein in 1 patient with right upper urinary tract calculus. No venous thrombosis of renal vein or inferior vena cava was founded in the 6 patients. All 6 patients were managed with strict bed rest, intravenous antibiotics, and one-step or two-step tube withdrawal under close monitoring. One step method referred to total removal of nephrostomy tube under ultrasonic monitoring. Two step method referred to retracting the end of nephrostomy tube into the renal sinus under CT monitoring in the first step, then the nephrostomy tube was completely removed under ultrasound monitoring.Results:All 6 patients were successfully managed with strict bed rest, intravenous antibiotics, and one-step or two-step tube withdrawal under close monitoring. The tube was withdrew by one-step method in 1 patient, by two-step method in 5 patients. The original operations were performed successfully under close observation in 4 patients during the same hospitalization and in 1 patient during the next hospitalization. Other type of operation in 1 patient was performed during the next hospitalization. The all 6 patients were discharged uneventfully. The stone was cleared.Conclusions:Intravenous misplacement of a nephrostomy tube is mainly diagnosed by CT. The nephrostomy tube should be sealed immediately after diagnosis. The intravenously misplaced nephrostomy tube can be successfully removed by one-step or two-step withdrawing under close monitoring. Upper urinary tract stones can be successfully treated at the same time or by stages.

Objective:To explore the effectiveness of 1+N+N team model with family physician as the core for rehabilitation of community-dwelling stroke patients.Methods:Convalescent stroke patients in Fenglin Community of Shanghai Xuhui District, who were followed up and registered from January 2019 to October 2021, were continuously enrolled in this intervention study. The 1+N+N care team consisted of a family doctor as the core (“1”) with the professional and technical team of the community health service center (“N”) and specialists in second or third hospitals (“N”). Patients were randomly divided into 1+N+N intervention group and control group. The control group was treated with traditional stroke management scheme, while the intervention group was treated by the 1+N+N team model. The activities of daily living (ADL), motor function and psychological status scores were evaluated at baseline and 12 months after intervention. Multivariate linear regression model was used to analyze the association of intervention methods with the improvement of ADL score, motor function score and psychological status score of patients.Results:A total of 120 patients were enrolled (60 in each group), including 59 males and 61 females with a mean age of (71.5±6.8) years. Compared with the control group, the age of patients in the intervention group was younger ( P=0.013), and the proportion of patients with coronary heart disease was lower ( P=0.003). There was no significant differences in other variables between the two groups ( P>0.05). After 12 months of intervention, the scores of ADL, motor function and psychological status were significantly improved compared with those before intervention in both groups ( P<0.01). There was no significant difference in motor function scores between the intervention group and the control group before intervention ( P>0.05), but the scores of ADL and psychological status in the intervention group were higher than those in the control group ( P<0.001). After intervention, the above scores in the intervention group were higher than those in the control group ( P<0.01). After adjusting for confounding factors, multivariate linear regression showed that the 1+N+N team model had no significant correlation with ADL score ( t=0.27, P=0.799), but had a positive correlation with motor function score ( t=15.64, P<0.01) and psychological status score ( t=13.70, P<0.01). Conclusion:The 1+N+N team model can effectively improve the daily living ability, motor function and psychological status of stroke patients in the convalescent period, and the intervention effect on the latter two is better than that of the traditional rehabilitation mode.

Based on the analysis of the existing problems and implementation dilemmas in family doctor contracting and first-return-visits faced by primary medical institutions in China, the authors propose countermeasures to provide reference for managers of primary health care institutions.