OBJECTIVETo provide evidence for intervention measures on safe injection through a survey on the safety of injection in the health facilities in Wulong county, Chongqing city, China.

METHODSAn investigation on injection safety was conducted among health care providers with a uniform questionnaire.

RESULTSGlass syringes which were not appropriately sterilized was found in 52.2% (12/23) of the health facilities. Injection practices were not correct in 31.4% (11/35) of the health facilities. Used disposable syringes were discarded directly without any disposal in 63.6% (21/33) of the health facilities. At least one of the unsafe injection practices mentioned above existed in 77.1% (27/35) of the health facilities.

CONCLUSIONSThe main unsafe factors in the practice of injection are included: the practice to change needle but not syringe in penicillin allergic test and the injuries caused by used disposable syringes in medical staff. The important measures to improve injection safety were to train the medical staff on the knowledge about safe injection and the risks caused by unsafe injection, and to equip the health facilities with safe tools to destroy the used disposable syringes.

Adult ; China ; epidemiology ; Cross-Sectional Studies ; Disinfection ; statistics & numerical data ; Disposable Equipment ; statistics & numerical data ; Equipment Reuse ; statistics & numerical data ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Injections ; adverse effects ; statistics & numerical data ; Male ; Risk Factors ; Rural Health Services ; Safety ; Sampling Studies ; Surveys and Questionnaires ; Syringes

OBJECTIVETo explore risk factors of injection-related sharp injury and to provide safety injection guidance to healthcare takers.

METHODSA cross-sectional survey and 1:1 case-control study was used to study the epidemiological features and risk factors of sharp injuries among 3010 clinical nurses and nurse students from 13 hospitals in Guangzhou. Logistic multiple factor analysis was used.

RESULTSEighty-seven point five percent of nurses have suffered injuries at last once time. During the past month, 37.6% of the nurses have suffered injuries at least once time. The frequency of the injuries was 0.84 per person month. Through multiple logistic regression analysis, data showed that the risk factors leading to the sharp injuries in orders were: contacting the needle more frequently, subjectively thinking that the sharp injuries as unavoidable, the atmosphere in the nursing unit was not harmonious enough, recapping habit, carelessness at work, too many patients that not cooperating, breaking the ampule off without using carbasus, crowded and noisy working place, lack of acknowledge on prevention, lack of the awareness on how to avoiding the accident, having an initiative and creative personality etc.

CONCLUSIONThe results provided a foundation for the department of infection control in the hospital and sanitary administration department to constitute safety injection policies.

Case-Control Studies ; China ; epidemiology ; Cross Infection ; epidemiology ; etiology ; prevention & control ; Cross-Sectional Studies ; Female ; Hand Injuries ; epidemiology ; etiology ; Humans ; Injections ; Logistic Models ; Male ; Needles ; Needlestick Injuries ; epidemiology ; Nursing Staff, Hospital ; Retrospective Studies ; Risk Factors ; Surveys and Questionnaires

OBJECTIVETo estimate the frequency of injections and proportion of unsafe injections and to analyses the critical determinants of poor injection practices in general population in China. Also, to study knowledge, attitudes, practice research in providers and general population.

METHODSA random sample consisting residents and health care providers in a rural county was elected and interview about the frequency of received injection, as well as knowledge, attitudes and practices regarding injections were studied.

RESULTSOverall, 1 004 village residents, and 94 providers were interviewed. Among residents, 145 persons (14.4%), with 457 times (0.46 times per person) had received at least one injection during the previous 3 months. The frequency of injection was 1.84 per year. The proportion of received injections on treatment and immunizations was significantly different among > 12 years age group and < or = 12 years age group. Ninety-four point four percent of disposable syringes/needles were used for injections. Knowledge among the population and providers regarding injection safety was limited.

CONCLUSIONInjections were moderately frequent in this rural area and the proportions of disposable syringes/needles used for injections was very high. Knowledge of safe injection and reasonable injection as well as consciousness of self-protection in the providers and residents need to be improved.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Disposable Equipment ; statistics & numerical data ; Equipment Reuse ; statistics & numerical data ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Infant ; Injections ; adverse effects ; statistics & numerical data ; Male ; Middle Aged ; Risk Factors ; Rural Health Services ; Safety ; Surveys and Questionnaires ; Syringes

OBJECTIVETo study the risk factors of Acinetobacter baummanii in nosocomial infections, and to verify the nature of Acinetobacter baumannii strains isolated from intensive care unit (ICU).

METHODSA hundred and fourty patients associated with nosocomial infection of Acinetobacter baummanii from four teaching hospitals were selected and compared with controls through a case control study to identify risk factors. The strains isolated from the ICU were typed by polymerase chain reaction (PCR) with the primer M(13) following electrophoresis in agarose gel.

RESULTSThe odds ratios (ORs) were: state of the illness (OR = 8.69), using immunosuppressant (OR = 4.85), mechanical ventilation (OR = 3.68) and treatment with 3 kinds of antibiotics (OR = 3.014). Data from PCR studies indicated that these strains were sharing identical band pattern from the five strains.

CONCLUSIONRisk factors for nosocomial infection with Acinetobacter baummanii included state of an illness, immunosuppressant, mechanical ventilation, and treatment with antibiotics. A multidrug-resistant strains of Acinetobacter baumannii was identified in ICU.

Acinetobacter baumannii ; classification ; genetics ; Cross Infection ; etiology ; microbiology ; Genotype ; Humans ; Logistic Models ; Polymerase Chain Reaction ; Risk Factors

OBJECTIVEUsing Markov model Monte Carlo simulation to conduct a cost-effectiveness analysis of screening Helicobacter pylori (H. pylori) infection to prevent gastric cancer.

METHODSThe Markov model was developed based on the natural course from H. pylori infection to gastric cancer. Two strategies were compared: (1) screening for H. pylori and treatment for those with positive tests, and (2) without screening and treatment. Data used for model simulation including transition probability, efficacy of test and treatment were collected from related research publications. Markov model Monte Carlo simulation combined with bootstrap method was used to perform base-case analysis and estimate the confidence interval of cost-effectiveness ratios. The probability sensitivity analysis was used to estimate the cost-effectiveness in multiple uncertainty factors.

RESULTSAssuming H. pylori eradication will prevent 50% of attribute gastric cancer, the screening strategies would prevent 16.6% cases of gastric cancer. Cost-effectiveness were 10,405 Yuan (95% CI: 4,238 - 27,727 Yuan) per GC prevented, 64 Yuan (95% CI: 31 - 97 Yuan) per QALY saved and 1,374 Yuan (95% CI: 352 - 86,624 Yuan) per life year saved.

CONCLUSIONScreening and treatment for H. pylori infection in population was potentially effective in the prevention of gastric cancer, and screening in high incidence area of gastric cancer would be more effective and economic.

Cost-Benefit Analysis ; Helicobacter Infections ; complications ; diagnosis ; Helicobacter pylori ; isolation & purification ; Humans ; Markov Chains ; Probability ; Stomach Neoplasms ; prevention & control

OBJECTIVEThe goals of this work was to analyse the cost of Shenqi Fuzheng injection-an extraction of a Chinese traditional herbs on reducing adverse effects in lung cancer patients during chemotherapy.

METHODSIn a randomized cross-over trial, each patient completed two identical cisplatin-based chemotherapy cycles, one with Shenqi Fuzheng injection, another without Shenqi Fuzheng injection. Adverse effects and change scores of quality of life (QOL) during chemotherapy were compared in tow cycles. The direct cost dealing with adverse effect and cost-effectiveness analysis were taken.

RESULTSOne hundred and thirty were enrolled with 123 of whom were evaluable. The patient characteristics were well balanced between the two groups. The chemotherapy cycles with Shenqi Fuzheng injection spent 220.5 more Chinese yuan, but the adverse effect of leukopenia, thrombocytopenia and vomiting were slight different and the change of score of several QOL domains showed significant better as compared to those in another cycle.

CONCLUSIONShenqi Fuzheng injection could reduce the severity of toxicity related to chemotherapy and improve the QOL of patients and had some benefits in terms of cost-effectiveness.

Aged ; Antineoplastic Agents ; adverse effects ; Cost-Benefit Analysis ; Costs and Cost Analysis ; Cross-Over Studies ; Drugs, Chinese Herbal ; economics ; therapeutic use ; Female ; Humans ; Injections ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged

OBJECTIVETraditional prenatal diagnosis for congenital diseases were villus sampling and amniocentesis. These invasive diagnosis methods are not only technical complicated, but also harmful to mother or fetus. Fetus in its different gestational age has its different type of hemoglobin or different amount of hemoglobin, especially epsilon hemoglobin exiting in the body of 10 weeks gestation fetal, however gamma hemoglobin has its high amount before baby to be born. But epsilon and gamma hemoglobin did not exist in the bodies of adults bodies. It is possible to use advanced molecular biological technique to extract the fetal hemoglobin gene from maternal peripheral blood. In articles from domestic and abroad, no report related to fetal hemoglobin extraction from maternal peripheral blood was found. We tried to use non-invasive method to detect fetal hemoglobin epsilon/gamma gene from maternal peripheral blood by molecular biological technique. The purpose was to establish a convenient, sensitive and special method to be a basis of screening prenatal diseases in the population and lay a basis for family planning and clinical application.

METHODSBlood samples were collected and the fetal mRNA extracted from the pregnant women with the use of random primer. We used ultraviolet spectrophotometer to test the concentration and purity of extracted mRNA are suitable for reverse transcription. Reverse transcription of mRNA into cDNA was carried out and cDNA by PCR with the special epsilon/gamma primer being used. Via 1.2% EB in agarose gel electrophoresis, we used "Gel Works System" to scan the electrophoresis image to detect epsilon/gamma gene band.

RESULTSThe peripheral blood of pregnant women was collected. With RT-PCR and agarose gel electrophoresis method, we detected epsilon/gamma gene successfully in 7 samples with 6 positive and 1 negative.

CONCLUSIONThis was the first time that we used non-invasive way to detect expression of fetal epsilon/gamma gene in maternal blood to have found that this was a simple method to separate fetal cells from maternal blood, and could easily be accepted by pregnant women. Success of RT-PCR to detect fetal specific mRNA gave the hint that this method could be used in the field of prenatal diagnosis of hemoglobin disease, predicting fetal gender, predicting Rh blood type and single gene disease and be used widespread in prenatal diagnosis.

Female ; Globins ; genetics ; Humans ; Pregnancy ; blood ; RNA, Messenger ; blood ; Reverse Transcriptase Polymerase Chain Reaction ; methods

OBJECTIVEA number of putative virulence factors have been postulated to be relevant to the clinical outcome of Helicobacter pylori infection based on strains identified in the western countries. The aim of this study was to investigate the association between genotypes of vacA, cagA and iceA and duodenal ulcer disease in patients from Hong Kong.

METHODSSeventy-two dyspeptic patients with or without duodenal ulcer disease, with proven H.pylori infection, were studied. Gastric biopsy specimens were analyzed by specific polymerase chain reaction and Southern blot to determine the genotypes of these virulence factors.

RESULTSExcept 6 (8.3%) cases with evidence of multiple infections, all of the remaining 66 cases had vacA signal sequence s1 type strains. Twenty-seven (90%) of the 30 cases with duodenal ulcers were infected with cagA-positive strains, compared with 32 (88.9%) of 36 with non-ulcer dyspepsia (P > 0.05). Similarly, vacA middle region sequences were detected with no significant difference in the two groups, 9 (30.0%) versus 13 (36.1%) for m1b and 21 (70.0%) versus 23 (63.9%) for m2 type. IceA1 subtype was detected in the same frequency in 42 (63.6%) of the 66 cases. Neither cagA nor vacA and iceA were associated with duodenal ulcer disease.

CONCLUSIONNo clear differences were found in the distribution of cagA, vacA and iceA genotypes among patients with duodenal ulcer or non-ulcer dyspepsia. The association of these virulence genes and duodenal ulcer disease needs reappraisal, particularly under geographic considerations.

Antigens, Bacterial ; genetics ; Bacterial Proteins ; genetics ; Duodenal Ulcer ; etiology ; Genotype ; Helicobacter pylori ; pathogenicity ; Humans ; Middle Aged ; Virulence

OBJECTIVETo investigate the antimicrobial susceptibility,auxotype, and plasmid profile of Neisseria gonorrhoeae isolates in China and to provide evidence for the development of treatment guideline and policy for control.

METHODSAgar dilution was used to detect antimicrobial susceptibility. The auxotype was determined by GC genetic medium. The plasmid was extracted by alkaline cleavage and electrophoresed.

RESULTSA total of 4,976 gonococcal isolates were tested in the last 8 years. The resistant rate for penicillin was 71.60% with PPNG being 15.54%. Tetracycline-resistant (TRNG) isolates accounted for 93.02% with 10.48% high level tetracycline-resistant. The resistant rate for ciprofloxacin was also relatively high (31.78%). The resistant rates for spectinomycin and ceftriaxone were 0.36% and 0.46%. The predominant auxotypes of gonococcal isolates were proto and pro(-) during 1995 - 1996 in Nanjing, accounted for 46.4% and 47.53%, 48.4% and 50.22%, respectively. There were 8 strains harboring 4.2, 5.4, 39.5 kb plasmids and 2 harboring 4.2, 4.9, 5.4, 39.5 kb plasmids in 10 PPNG strains; 2 harboring no plasmid, 28 harboring 4.2, 4.9, 5.4, 39.5 kb plasmids in 30 non-PPNG strains. The 5.4 kb plasmid of PPNG could be digested with restriction endonuclease BamHI while the 5.4 kb plasmid of non-PPNG could not.

CONCLUSIONThe gonococcal isolates were highly resistant to penicillin, tetracycline, and ciprofloxacin, while were still sensitive to spectinomycin and ceftriaxone. No significant auxotyping change was found in terms of predominant gonococcal strains in the last two years in Nanjing while 5.4 kb plasmid might be the most prevalent resistant plasmid in Nanjing.

China ; Drug Resistance, Bacterial ; Microbial Sensitivity Tests ; Neisseria gonorrhoeae ; drug effects ; isolation & purification ; Time Factors

OBJECTIVETo identify the risk factors and socio-psychological condition of epilepsy in general population.

METHODSA community-based, pair-matched case-control study using the epileptic patients living in Zhujing town, Jinshan district, Shanghai was carried out. Patients were matched for age (+/-1 years) and gender to controls (81 cases and 81 controls). Data was analyzed with multiple conditional logistic regression.

RESULTSAs a result of multiple logistic regression, postnatal insults (OR = 6.517), alcohol intake (OR = 10.761) and family history (OR = 5.414) were powerfully associated with epilepsy. Compared with control group, epileptic patients were significantly different in socio-psychological condition, especially in > or = 17 years adult patients.

CONCLUSIONPostnatal insults, alcohol intake and family history were the risk factors of epilepsy. Psychological and psychiatric disorders were highly prevalent among epilepsy patients.

Case-Control Studies ; Epilepsy ; etiology ; psychology ; Female ; Humans ; Logistic Models ; Male ; Risk Factors