The major pathogenic bacterium of catheter-related bloodstream infection is gram-positive bacteria.The occurrence of catheter-related bloodstream infection is related with exogenous factors and endogenous factors.It is suggested that catheter-related bloodstream infection should be diagnosed without removing the catheter.It is shown that the catheter should be removed and the patient should use antibiotics as soon as possible if catheter-related bloodstream infection occurred.Buliding a detection system,using antimicrobial dressings and antimicrobial central catheters,and improving patient's nutritional status can decrease the morbidity of catheter-related bloodstream infection.The authors summarize the epidemiology,diagnosis,treatment and prevention strategies of catheter-related bloodstream infection.

Objective To explore the curative effect of traditional Chinese herbal packet combined with ST 36 injection therapy on gastrointestinal dysfunction in severe patients. Methods Sixty severe patients with gastrointestinal dysfunction were randomly divided into the control group and treatment group with random digital number, 30 cases in each group. The control group received conventional care and besides conventional care , the treatment group was treated with traditional Chinese herbal packet combined with ST 36 injection. The two groups were compared 7 days after treatment in terms of scores by (acute physiology and chronic health evaluationⅡ, APACHEⅡ) and improvement of gastrointestinal dysfunction. Result After treatment, the APACHE II score and improvement of gastrointestinal dysfunction of the treatment group were significantly higher and better than those of the control group (P<0.05). Conclusion The traditional Chinese herbal packet combined with ST 36 injection can promote the recovery of gastrointestinal dysfunctional in severe patients.

Objective To compare the effect of GammaTM wet wipes and 75% alcohol on the disinfection of X-ray protective clothing,and provide reference for choosing rational disinfection methods.Methods 62 pieces of X-ray protective clothing were selected,30 were from operating rooms,32 from catheterization room.Protective clothing were randomly divided into trial group and control group,each had 31 pieces.Trial group disinfected clothing with GammaTM wet wipes,control group disinfected clothing with 75% alcohol,disinfection effect,drying time,and cost between both groups were compared.Results Average bacterial colony counts in trial group and control group before disinfection were 2.38 CFU/cm2 and 2.36 CFU/cm2 respectively,qualified rates were 80.64% and 83.87%respectively.Bacteria were not detected in both groups after disinfection.The average drying time in trial group was shorter than control group([352.35±9.93]s vs[676.13±10.62]s,t=123.98,P <0.01).The cost of disinfecting X-ray protective clothing in trial group was 29.60% less than control group.Conclusion Effect of GammaTM wet wipes and 75% alcohol on disinfecting X-ray protective clothing are both reliable,compared with 75% alcohol, GammaTM wet wipes are without corrosion,have shorter drying time,and save more cost.

ObjectiveTo investigate the risk factors and pathogenic characteristics of catheterrelated infection (CRI) in intensive care unit (ICU),so as to find a better way for its treatment.Methods Retrospective analysis was performed on 247 deep-venous catheter (DVC) from January 2007 to December 2010.ResultsAmong 247 patients,positive results of 41 patients diagnosed CRI,negative results of 206 patients undiagnosed CRI.Compared with undiagnosed CRI patients,found the correlation of the underlying infectious diseases,indwelling time of catheter and puncture sites associated with CRI occurred(P ＜ 0.05 ).CRI major pathogen was gram-positive bacteria (58.5％,24/41 ),in which Staphylococcus epidermis was the major pathogenic bacteria(22.0％,9/41).The drug resistance occurred in most pathogen.Conclusions The occurrence of CRI is related with multiple clinical factors.The gram-positive bacteria is the major pathogen.The etiological monitor should be enforced in patients with DVC.

To evaluate the status of diabetes-related knowledge and training requirement among general physicians,a questionnaire survey was conducted in 676 general physicians from 32 primary medical institutions and 5 secondary hospitals of Shanghai Pudong New Area.48.2% (261/541) of the surveyees had bachelor degree and most of them worked in secondary hospitals or primary medical institutions in affluent areas.The awareness rate of diabetic knowledge among the surveyeos was 51.6%,and there were significant differences in the awareness rate of diabetes-related knowledge between different levels of hospitals and physicians with different academic background.Only 26.6% of physicians received diabetes-related continuing education or training,there was a popular request for professional training from the surveyed physicians.

Objective:To investigate the clinical effect of recombinant human growth hormone (rhGH) in the treatment of children with growth hormone deficiency and its effect on thyroid function.Methods:From June 2016 to June 2018, 81 children with growth hormone deficiency in Da Jiangdong Hospital of Hangzhou were selected.The rhGH was given 1 time before bedtime, and the treatment course was 6 months.The growth and development, bone metabolism and thyroid function were compared before treatment, 3 months and 6 months after treatment.Results:The height and growth rate at 3 months after treatment [(131.76±2.28)cm, (10.40±0.87)cm/year] and at 6 months after treatment [(134.83)cm, (11.74±0.72)cm/year] were higher than those before treatment [(127.32±3.49)cm, (4.32±1.08)cm/year] ( F=7.973, P=0.000, F=12.314, P=0.000), which at 6 months after treatment were higher than those 3 months after treatment (height: t=9.586, 16.405, growth rate: t=39.457, 51.448, P=0.000). There was no statistically significant difference in BMI among before treatment [(17.21±4.28)kg/m 2], 3 months after treatment [(17.86±5.14)kg/m 2] and 6 months after treatment [(18.01±4.35)kg/m 2] ( F=0.762, P=0.391). The serum levels of BGP and ALP at 3 months after treatment [(7.19±0.38)ng/mL, (129.34±8.97)U/L] and at 6 months after treatment [(7.94±0.63)ng/mL, (154.67±10.42)U/L] were higher than those before treatment [(6.38±0.57)ng/mL, (108.49±6.51)U/L] ( F=8.971, P=0.000, F=15.427, P=0.000), and the levels of BGP and ALP at 6 months after treatment were higher than those 3 months after treatment ( t=9.175, P=0.000, t=16.581, P=0.000). There were no statistically significant differences in serum FT3, TSH and FT4 levels before treatment, 3 months after treatment and 6 months after treatment ( F=0.893, P=0.287, F=0.472, P=0.517, F=1.084, P=0213). Conclusion:rhGH has significant clinical effects on children with growth hormone deficiency, and has no significant effect on thyroid function, which is worthy of clinical reference.

Background and purpose:HPV infection is known as the primary cause of cervical cancer worldwide To investigate high risk type human papillomavirus (HPV) prevalence and incidence rates of cervical intraepithelial neoplasia (CIN) and their screen risk factors in women with different methods of screening.Methods:1137 residents, workers and service women aged 15-59 from Shenzhen city were investigated for cervical cancer in an epidemiology screening study.The high risk types of human papillomavirus of liquid-based cytology samples were tested by hybrid capture 2 (HC-Ⅱ) and liquid-based cytology test (LCT) was also performed at the same time. Women for HPV-positive with LCT ≥ atypical squamous cells of undetermined sign (ASCUS) or HPV-negative with LCT ≥ low grade squamous intraepithelial lesion (LSIL) were biopsied in colposcopy and then were examined by pathology. All data was managed by Foxbase. ?2 test and unconditional Logistic regression model were used for data analysis by SPSS 10.0.Results:1137 women were eligible in our research, the overall rates of HPV infection was 14.0%. HPV detection rates in residents, workers and service women were 14.1%,9.2%,18.9% respectively. HPV detection rates in workers group was significantly lower than that of service women and residents (P

Objective To investigate the effects of club mode of health education on social support of breast cancer patients and their spouses.Methods A total of 100 breast cancer patients who underwent modified radical mastectomy and their spouses in Suzhou Municipal Hospital from May 2012 to March 2013 were randomly divided into the intervention group and the control group with 50 cases respectively. Patients and spouses in the intervention group were involved in the club, while in the control group patients and spouses received routine nursing care. Perceived social support scale (PSSS) and social support ratings scale (SSRS) were used in the questionnaires for patients before the intervention and at the 1st month, 3rd month, 6th month after the intervention.Results In the intervention group, the score of the support on the patients out of family was (29.80±5.77) at the 1st month after the intervention; the total score of perceived social support was (57.22±5.26) at the 3rd month after the intervention; the score of support from family was (26.59±2.51) at the 6th month after the intervention. All of those scores were significant higher than those in the control group (F=6.391, 0.304, 7.435;P<0.05). At the 3rd month after the intervention, the score of the social support on the spouses were (45.02±6.40) in the intervention group and (39.17±7.77) in the control group. The difference between the two groups was statistically significant (F=1.250,P<0.05).Conclusions The club mode of health education can effectively improve the social support status for breast cancer patients and their spouses.

Objective Our purpose was to investigate the pathogenic gene mutation of a Han Chinese family with vitreous amyloidosis.Methods The 9 individuals(proband,1 affected member and 7 unaffected members) of the family were selected and their DNA was extracted from peripheral blood.The 4 exons of transthyretin(TTR) gene were amplified by polymerase chain reaction(PCR) technique.The amplified products of TTR gene were sequencing by Sanger technique.We also selected 100 unrelated healthy individual as the control group.Results By DNA sequencing,a heterozygous mutation was found in 4 of the 9 subjects from the family.The transition of adenine to cytosine(AAG ＞ ACG) was detectable in exon 2 of TTR,which changed the amino acid composition at codon 35 (Lys35Thr).This mutation did not presented in control group.Conclusion The heterozygosis mutation of TTR gene Lys35Thr should be a pathogenic mutation for the family with vitreous amyloidosis.

OBJECTIVETo assess the safety and clinical efficacy of transjugular intrahepatic portosystemic shunt (TIPS) with various stents for treating patients with cirrhosis and esophageal gastric varices bleeding.

METHODSOne hundred and five patients were stratified according to stent type: bare stent group, covered stent-grafts group, combined stents group. Rates of success, shunt insufficiency, rebleeding, patient survival, and major complications were observed. The shunt insufficiency rate, rebleeding rate, and survival rate were calculated by the life tables method, the Kaplan-Meier analytical curve, and the log-rank test; a p-value less than 0.05 was considered statistically significant.

RESULTSThe overall success rate of all TIPS for treating the esophageal gastric varices bleeding was 100%. The overall shunt insufficiency rates at 6-, 12-and 24-months post-TIPS were 8%, 9% and 16%, rebleeding rates were 2%, 6% and 17%, and survival rates were 100%, 97% and 94%. The shunt insufficiency rate was 26% in the bare stent group, 14% in the covered stent-grafis group, and 5% in the combined stents group (x2=1.00, P=0.61). The rebleeding rate was 33% in the bare stent group, 7% in the covered stent-grafts group, and 3%in the combined stents group (x2=1.69, P=0.43). The survival rate was 92% in the bare stent group, 93% in the covered stent-grafts group, and 100% in the combined stents group (x2=1.91, P=0.39). The shunt insufficiency rates were higher in patients with splenectomy than in those without splenectomy (30% vs.14%; x2=4.15, P=0.04). The intraperitoneal hemorrhage rates in the covered stent-grafis group and the combined stents group were significantly lower than that in the bare stent group (0% vs 0% vs 13%; x2=8.88, P=0.01).

CONCLUSIONSTIPS with an 8 mm stent effectively treated and prevented esophageal gastric varices bleeding in patients with cirrhosis. Intraperitoneal hemorrhaging caused by TIPS was significantly decreased in the covered stent-grafts group and combined stents group,which represented an improvement in safety of this treatment. However, the influence of covered stent-grafis and combined stents towards the clinical efficacy of TIPS needs further study.