OBJECTIVE:To provide reference for avoiding the recurrence of medical safety(adverse)events or inducing more severe medical accident. METHODS:The medical safety(adverse)events reported by a class A grade 3 hospital from July 2013 to March 2016 were studied retrospectively,and excluded purely adverse drug reactions and transfusion reactions to analyze the rea-son and characteristics. RESULTS:Of 747 events,there were 578 medical,nursing and drug-related medical safety (adverse) events,accounting for 77.38%;among 175 medical related medical safety(adverse)events,top 3 reasons were basic skills defi-ciencies,defects in the system processes,inadequate communication and education, accounting for 32.00%,24.00%,19.43%. The occurrence of medical safety (adverse) events were closely related to working life and qualifications;among 578 medical, nursing and drug-related medical safety (adverse) events,the incidence of adverse events was 71.11% in 5-year working life group,and that was 73.18% in junior titles group. CONCLUSIONS:Various professionals should strictly implement procedure and regulations,strengthen communication and education in daily work,and improve professional knowledge and skills so as to prevent the occurrence of adverse event completely.

Objective To identify the independent prognostic factors for femoral head avascular necrosis after internal fixation of femoral neck fractures.Methods A retrospective analysis was made on 246 patients (246 hips) with femoral neck fractures treated by internal fixation between January 2002 and January 2010.There were 111 male and 135 female patients aged 19-59 years.A total of 101 patients were injured in traffic accidents,79 patients in falls from the height and 66 patients in ground-level falls.Eight parameters were identified as the prognostic factors of femoral head avascular necrosis,including gender,fracture type,preoperative traction,interval from injury to surgery,reduction methods,quality of fracture reduction,time of weight bearing,and fixation removal.Multivariate Logistic regression analysis was used to explore the risk factors of postoperative femoral head avascular necrosis.Results Period of follow-up was 1-13 years (mean,7.5 years).There were 38 patients (15.4％) with avascular necrosis of the femoral head.Multivariate analysis identified fracture type (95％ CI-3.41--2.43,P ＜ 0.01),preoperative traction (95％ CI-3.77--0.6,P ＜ 0.05) and quality of fracture reduction (95％ CI -3.33--0.94,P ＜ 0.01) as the independent predictors of avascular necrosis of the femoral head.Conclusion Fracture type,preoperative traction and quality of fracture reduction are the independent risk factors for avascular necrosis of the femoral head after internal fixation of femoral neck fractures.

Objective To investigate the relationship between watching television time and impaired glucose regulation (IGR) , type 2 diabetes mellitus in Chongqing City .Methods Population-based cross-sectional study was conducted to investigated the local permanent staff(lived in Chongqing more than 5 years) who were 40 years old or elder in Chongqing City .Results The overall prevalence rate of IGR and T 2DM was 6 .3% ,5 .6% respectively .The average weekly watching TV time of the samples was (12 .3 ± 10 .1) h .After adjusting for possible confounding factors ,the prevalence rate of IGR and T2DM in patients watching TV time >14 h per week was significantly higher than those watching TV time ≤ 7 h per week(Adjust .OR = 1 .528 ,95% CI = 1 .034 - 2 .121 ;OR = 1 .482 ,95% CI = 1 .133 - 2 .047 ,respectively ) .Conclusion Siting and watching TV time were positively correlated with the risk of IGR ,T2DM .So ,we should actively encourage and promote healthy lifestyles to reduce siting and watching TV time .

Objective To investigate the variation of morbidity and clinical features of Henoch-Seh(o)nlein purpura (HSP) in childhood in recent years.Methods The clinical data of 901 cases with HSP admitted to our hospital from January 1,1995 to December 31,2005 were retrospectively analyzed.The constitute rate of admission,the initial clinical presentations,specific manifestations such as multi-system 23/2165(1.06%),29/2098(1.38%),24/1973(1.22%),39/2008(1.94%),54/2433(2.22%),86/2611(3.29%),94/2724(3.45%),99/3014(3;28%),138/2900(4.76%),143/3177(4.50%)and 172/3500(4.91%),resp-sixty-five of 901 HSP children (1 8.3%) had no palpable purpura at onset, 90 cases initially manifested as abdominal pain and (or) gastrointestinal bleeding,14 of them was diagnosed by gastroendoscopy which demonstrated mucous membrane vasculitis.Sixty-three cases manifested as arthritis/arthralgias,6 cases presented as renal involvement,1 case with neurological symptoms and 5 cases with other symptoms at their pancreatic involvement was present in 3 cases,cardiac involvement in 47 Cases and one case had lung hemorrhage.Conclusion The morbidity of HSP has increased in recent years.The diagnosis in patients who do not have palpable purpura at onset and patients who present with the cerebral,pulmonary,cardiac and pancreatic involvement as the initial manifestations is difficult.Special attention should be paid to this group of patients.Gastrointestinal endoscope is valuable in diagnosing HSP in patients whose initial symptoms are abdominal pain and (or) gastrointestinal bleeding.

Objective To analyze the relationship between the radiation doses to mediastinal lymph nodes regions and the regional failure patterns when involved field radiation therapy (IFRT) was used for limited-stage small cell lung cancer (SCLC).Methods The mediastinal lymph node regions (group 1 to 10) of the iimited-stage SCLC patients received definitive radiotherapy were contoured in treatment planning system.The intentional or incidental radiation doses to each lymph node regions were recorded.In-field recurrence,marginal recurrence and out-of-field recurrence were respectively defined as the volume of failed lymph nodes located within the 80％ iso-dose lines,in the 80％-20％ iso-dose lines and beyond the 20％ iso-dose lines of prescribed doses.Results A total of 1 216 lymph node regions in 76 patients were contoured.The median follow-up time was 17.4 months.At diagnosis,lymph node regions with metastatic rates ＞50％ were 4R (68.7％),4L (57.9％),10R (57.9％),2R (56.6％) and 7 (51.3％).The positive lymph node regions were all subjected to prescribed doses.The lymph node regions that received incidental radiation doses of more than 3 000 cGy were:3P,4L,7,6,4R,5,2L.The median lymph node failure-free time was 9.8 months.In this study,only 1 patient developed out-of-field mediastinal lymph nodes failure.The rest of out-of-field recurrences and marginal recurrences were developed in the supraclavicular regions or contralateral hila.Conclusions When IFRT is used to treat mediastinal lymph node regions for patients with SCLC,negative mediastinal regions can be subjected to considerable incidental radiation doses.Out-of-field recurrences of the mediastinal lymph node regions are rare.This is contributed by the incidental radiation dose to these regions.

Objective To understand the basic situation of healthcare-associated infection(HAI)management and prevention and control of multidrug-resistant organism(MDRO)infection in medical institutions in Hubei Province.Methods Questionnaires were used to investigate the basic situation of HAI management and MDRO infection in 47 tertiary and secondary hospitals in Hubei Province.Results 47 hospital were enrolled in this study,HAI management full-time staff was allocated with a median of 0.90/250 beds;in 2015,the isolation rates of methicillin-resistant Staphylococcus aureus,carbapenem-resistant Enterobacteriaceae,carbapenem-resistant Pseudomonas aeruginosa,carbapenem-resistant Acinetobacter baumannii,and vancomycin-resistant Enterococcus were 39.13%,4.13%,19.44%,63.60%,and 2.77%respectively.47 hospitals all carried out surveillance on MDROs,28(59.57%)hospitals were installed HAI monitoring system software,could directly obtain data through collecting with the laboratory system.The diagnosis of MDRO infection was mainly based on the combined diagnosis by HAI full-time personnel and clinicians(26 hospitals,55.32%).44(93.62%)hospitals regularly convened coordination meeting on prevention and control of MDROs,in 2015,hand hygiene compliance rate were 10.0%-89.2%by self-inspection;42(89.36%)hospitals routinely prescribed isolation orders for patients with MDRO infection,33(70.21%)hospitals conducted environmental clean and disinfection twice a day,24(51.06%)hospitals performed personal protection by using complete set of protective equipment.Conclusion This investigation is helpful for understanding the general situation of HAI management in medical institutions,as well as the detection and control of MDROs in this area,and make continual improvement on the problems and weakness found in the investigated project,so as to promote the development of HAI management in this area.

After brief introduction of FISH (fluorescence in situ hybridization),it was discussed of the FISH's application status in research on biological nitrogen removal in recent years. Base on the FISH technology,Characterization of the community in biological reactor could be showed exactly,but more research should be carried out for the study on the effluence on microbial community composition,which was caused by changing operating parameter of biological reactors on the microbial community composition,such as SRT,DO and C/N ratio.The combination of FISH and other methods such as PCR-DGGE and 16S rRNA/rDNA will led to the identification of the microbial community which response for the nitrogen-removal in wastewater treatment plant.

OBJECTIVE:To investigate the regularity and characteristics of adverse drug reaction (ADR) in our hospital,to reduce the incidence of ADR,and to provide reference for clinical rational drug use. METHODS:1 731 ADR cases reported by our hospital during Jan. 2002 to Jul. 2015 to national ADR monitoring center through the network system were selected and analyzed statistically in respects of gender,age,related drugs,route of administration,causal relationship evaluation,reporting personnel status,ADR results and drug dosage form organs or systems involved in ADR and manifestation. RESULTS:There were a total of 1 731 ADR patients,among which 640 cases were male,and 1 091 cases were female;patients aged 41-60,≥61 were 676,568 cases;there were 86 cases of severe ADR and 1 645 cases of general ADR,249 cases of new ADR,include 19 cases of severe ADR;causal relationship evaluation of ADR was“impossible”(572 cases) and“very likely”(859 cases) as the vast majority of staff reporting;the most of reporters were doctors (1 290 cases,74.52%),followed by pharmacists (323 cases, 18.66%) and nurses (118 cases, 6.82%);ADR of most patients were improved and recovered. There were 16 routes of administration in ADR cases,among which intravenous infusion and oral administration were the main route of administration, accounting for 92.95%;ADR reports involved 32 kinds of dosage form,which mainly were injection,tablets and capsules, accounting for 86.76%. CONCLUSIONS:Great importance should be attached to ADR monitoring and reporting. We also should reduce the use of intravenous drugs,pay attention to the safety of drug use in elderly patients,promote clinical rational drug use, and ensure the safety of patients.

U-shaped sacral fractures are rare and often difficult to diagnose primarily due to the difficulty in obtaining adequate imaging and the severe associated injuries.These fractures are highly unstable and frequently cause neurological deficits.The majority of surgeons have limited experience in management of U-shaped sacral fractures.No standard treatment protocol for U-shaped sacral fractures has been available till now.This study aimed to examine the management of U-shaped sacral fractures and the early outcomes.Clinical data of 15 consecutive patients with U-shaped sacral fracture who were admitted to our trauma center between 2009 and 2014 were retrospectively analyzed.Demographics,fracture classification,mechanism of injury and operative treatment and deformity angle were assessed.All the patients were treated with lumbopelvic fixation or (and) sacral decompression.EQ-5d score was applied to evaluate the patients' quality of life.Of the 15 consecutive patients with U-shaped sacral fracture,the mean age was 28.8 years (range:15-55 years) at the time of injury.There were 6 females and 9 males.The mean followup time was 22.7 months (range:9-47 months) and mean full weight-bearing time was 9.9 weeks (range:8-14 weeks).Ten patients received lumbopelvic fixation and sacral decompression,one lombosacral fixation,and 4 merely sacral decompression due to delayed diagnosis or surgery.The post-operation deformity angle (mean 27.87°,and range:8°-90°) of the sacrum was smaller than that pre-operation (mean 35.67;range:15-90) with no significance difference noted.At the latest follow-up,all patients obtained neurological recovery with different extents.Visual analogue score (VAS) was reduced from preoperative 7.07 (range:5-9) to postoperetive 1.93 (range:1-3).All patients could walk without any aid after treatment.Eight patients were able to care for themselves and undertook some daily activities.Five patients had returned to work full time.In conclusion,lumbopelvic fixation is an effective method for stabilization of U-shaped sacral fractures with fewer complications developed.Effective reduction and firm fixation are the prerequisite of early mobilization and neurological recovery.Sacral decompression effectively promotes neurological recovery even in patients with old U-shaped sacral fractures.

Objective To determine whether hybrid three dimensional diffusion tensor imaging (3D DTI) contributes incremental value to standard T2WI technique for assessing neurovascular bundles (NVB) around the prostate. Methods This retrospective institutional review board-approved study included 69 consecutive patients with prostate tumor who underwent MRI including conventional T2WI and 3D DTI . DTI data were postprocessed and hybrid 3D DTI and axial T2W images were obtained. Three radiologists with one, five and thirteen years of experience in reading prostate MRI and one urologist with three years of surgical experience in urology who were blinded to patient data independently recorded their levels of preference on a five-point scale of the NVBs around the prostate on the basis of T2WI alone and hybrid 3D DTI and T2WI, respectively. The differences of scores of T2WI and hybrid 3D DTI and T2WI of the four doctors were compared by using nonparametric Wilcoxon rank. Results The average scores of hybrid 3D DTI to T2WI and alone T2WI to assess NVBs for 3 radiologists and one urologist were 4.4±0.6, 4.3±0.8, 4.2± 0.6, 4.9±0.3 and 2.9±0.8, 3.0±1.1, 1.6±0.7, 3.8±0.5, respectively. The hybird 3D DTI to T2WI improved the discrimination abilities of NVBs around the prostate for 3 radiologists and one urologist (Z values were-12.791,-9.737,-14.538,-14.901, P<0.01 respectively).The added value of hybrid DTI to T2WI for urologist is the highest, and experienced radiologist is the smallest. Conclusion The hybrid 3D DTI
contributes significant incremental value to the standard T2WI technique for assessing NVB around the prostate.