Objective To realize the current status of central sterile supply departments(CSSDs)in hospitals,and provide the basis for making improvement measures.Methods Field investigation was adopted to study the resource distribution,personnel structure,and the quality of medical instrument cleaning in 78 hospitals in Chongqing.Re-sults Qualified results of 78 hospitals was 24.36% (19/78),basically qualified rate 52.56% (41/78),unqualified rate 23.08% (18/78);inspection results of different types of hospitals were significantly different(Hc= 16.643,P=0.002),qualified hospitals mainly concentrated on city- and county-level hospitals.Unqualified rate of CSSD con-struction area was 78.21% (n= 61),unqualified rate of personal allocation was 75.64% (n= 59),concentrated man-agement of operating rooms and CSSDs was 52.56% (n= 41),mainly concentrated on city- and county-level hospi-tals;decentralized management accounted for 47.44% (n= 37),58(74.36% )hospitals used repeated cleaning stain-less steel tables for receiving,50% didn’t install automated cleaning machine and drying cabinet,42.31% (33/78) performed manual cleaning,40(51.28% )didn’t equip with water treatment system;12(15.38% )hospitals used patched or worn clothing for packing,47 didn’t equip with hard metal container,37(47.44% )had no heat sealing machine,21(26.92% )had no detection equipment for cleaning quality,41(52.56% )had no low temperature sterili-zation instruments;52(66.67% )hospitals performed biological monitoring on high pressure steam sterilizer.Conclu-sion Clean and disinfection equipments in CSSDs in city- and county-level hospitals are well-appointed,procedures of clean and disinfection are standard,and can achieve the standard of clean quality;while hospitals affiliated to fac-tories and private hospitals are not well-appointed,procedures of clean and disinfection are not standard. Construc-tion of CSSD should be standard,so as to ensure the effectiveness of clean,disinfection and sterilization of surgical instruments.

Objective To survey the clinical application of glycopeptide antibiotics in hospitalized patients, and evaluate the rationality of drug use, so as to provide reference for rational clinical drug use.Methods A retrospective study was conducted to investigate the application of glycopeptide antibiotics among inpatients in a hospital from January to December in 2014, relevant clinical data were recorded.Results A total of 727 cases were included , 471 (64.79%) of which were infected cases.Respiratory tract infection was the main site of both healthcare-associated infection and community-associated infection (39.17% and 45.98%, respectively).The average days of glycopeptide antibiotic use were 6.06 day (4 403/727).Patients who used glycopeptide antibiotics were mainly from intensive care unit, department of oncology, and department of neurosurgery, accounting for 20.36%(n=148) , 12.10%(n=88), and 11.14%(n=81) respectively.Glycopeptide was used in 338 patients(46.49%),the average types of combined use was 4.43, triple and above was used in 99 patients(13.62%),combination of the second generation cephalosporins was the highest(20.48%).450(61.90%) patients used vancomycin, 260(35.76%)used teicoplanin,17(2.34%)used both vancomycin and teicoplanin.A total of 847 pathogenic strains were isolated, the major were Acinetobacter baumannii (n=111, 13.10%), Klebsiella pneumoniae (n=80, 9.45%), Pseudomonas aeruginosa (n=68, 8.03%), and Staphylococcus aureus (n=54 , 6.37%), methicillin-resistant Staphylococcus aureus was 50 strains.490 (67.40%) patients treated with glycopeptide antibiotics were effective.Of 727 patients, 86 (11.83%) used antibiotics rationally, 315(43.33%) basically rational,and 326 (44.84%) irrationally.Conclusion Application of glycopeptide antibiotics in this hospital is basically rational, but indications should be paid attention.

Adolescent ; Child ; Child, Preschool ; DNA Mutational Analysis ; Diagnosis, Differential ; Humans ; Infant ; Infant, Newborn ; Liver Diseases ; diagnosis ; genetics ; pathology ; Lung Diseases ; diagnosis ; genetics ; pathology ; Magnetic Resonance Imaging ; Mutation ; Polycystic Kidney, Autosomal Dominant ; diagnosis ; genetics ; pathology ; Polycystic Kidney, Autosomal Recessive ; diagnosis ; genetics ; pathology ; Prenatal Diagnosis ; Receptors, Cell Surface ; genetics ; Tomography, X-Ray Computed

Objective To study some risk factors of acquired nosocomial pneumonia in tumor case nosocomial infection.Methods 77 tumor case with nosocomial infection were chosen as cases from the patients in hospital for 1:1 case control study.Results It was found that the fatality rate of acquired NP in tumor pattens was 14 3%.Some risk factors of acquired nosocomial infection in tumor case remained significant through logistic regression analysis showed,such as state of an immunosuppression therapy; operation,hospitalization duration,antibiotics application time and mechanical ventilation.Conclusions It was suggested that the iatrogenic pneumonia is comes from multiple risk factors and it should be paid attention. This is the most important step to control nosocomial infection of tumor case in the hospital happen.

OBJECTIVE To establish a rapid method of detecting class D carbapenemase gene in Acinetobacter baumannii by multiplex PCR.METHODS Design primers according to the conservative region of blaOXA-51 and blaOXA-23,the class D carbapenemase gene were detected by Multiplex PCR.RESULTS 24 of 30 A.baumannii isolates produced two bands of blaOXA-51 and blaOXA-23;other 6 isolates showed a band of blaOXA-23.CONCLUSIONS The multiplex PCR could detect rapidly the class D carbapenemase gene.

OBJECTIVE To explore the relationship between multidrug resistance of Acinetobacter baumannii(ABA) and its class Ⅰ integron.METHODS In this study,39 multidrug resistant strains and 41 non-multidrug resistant strains of ABA were collected.The improved Kirby-Bauer was employed to check the collected strains′ drug-resistant phenotype;PCR was administrated to detect the distribution of class Ⅰ integron.and their relationship was also analyzed.RESULTS Results showed that ABA′s drug-resistance rate to the most antibiotics was high.imipenem,cefoperazone-sulbactam,ABA was sensitive to ciprofloxacin,amikacin and Piperacillin-tazobactam,however,ABA′s drug resistance rates to other antibiotics were all over 40%.It revealed that ABA′s drug-resistance rate was high.The study indicated that the positive rate of Class Ⅰ integron in multidrug resistant ABA was as hight as 82.1%(32/39).The positive rate of non-multidrug resistant strains was 26.8%(11/41),and the differences were statistically significant(?2=24.6,P

Objective To evaluate the effect of vacuum suction on shaping sliming and breast anaplasty, to expand indications of vacuum suction, and to improve its result. Methods Based on injection of swelling solution more than routine dosage, vacuum suction was used in totally 825 cases, including local fat deposit in face or other sites of body, macromastia in female, hypermastia in male, lump after breast anaplasty by autograft of fat granule, as well as infection and induration after breast anaplasty by injection of polyacrylamide. Results Satisfactory rate of subjects to vacuum suction was up to 96 %, and clinical efficacy rate of the operation was 100 %. As to sliming cases, there were significant decreases in their measurements of figures or dimensions. In case of the lump from breast shaping by fat granule autograft, as well as the infection and induration caused by injection of polyacrylamide during breast anaplasty, vacuum suction could resolve all of them wonderfully. Conclusions When used properly, vacuum suction may play an excellent role in shaping sliming and breast anaplasty, and it can also resolve those complications brought up in breast shaping by fat granules autograftor and by polyacrylamide injection. Vacuum suction decreases the pain and cicatrisation caused by invasion surgery significantly.

The development and utilization of herbal medicinal resourses in south China were reviewed from the following aspects: (1) resources investigation; (2) introduction of South China herbal medicine (SCHM) to North China; (3) culture technology of green herbal medicine; (4) building of the base of good agriculture practice; (5) species study and quality evaluation of SCHM, and (6) product development of SCHM. It is concluded that the research on development and utilization of SCHM contributes a lot to reducing SCHM import, saving foreign exchange and ensuring the safety, effect, output stability and quality control in the production of medicinal material.

Objective To investigate the basic data and quality control indicators of infection monitoring in 67 hospitals in Chongqing area ,and provide basic data for the exploration of hospital infection monitoring norms .Methods According to the sur‐vey of the basic data and quality control index of hospital infection monitoring by the national health planning commission ,a ques‐tionnaire survey was conducted in some medical institutions in Chongqing area ,and the data were collected and analyzed .Results A total of 67 valid questionnaires were collected ,21 for tertiary hospitals ,46 for secondary hospitals ,of which there were 5 teaching hospitals ,47 general hospital ,11 hospital of traditional Chinese medicine ,3 factories hospitals ,1 private hospital .Electronic medical records management system in 67 hospitals accounted for 71 .64% ,the hospital infection information system accounted for 83 .33% ,surgical anesthesia system accounting for 31 .34% ,antimicrobial drug management and monitoring system accounted for 68 .65% .Hospital infection monitoring was mainly based on routine monitoring and target monitoring ,the correct rate of monito‐ring objects was 74 .62% ,and the usage of antibiotics was 44 .78% in the operation room .Monitoring statistics took month as a u‐nit ,accounting for 73 .13% ,the correct rate of P75 value was not high when calculating the risk factors of NNIS operation ,opera‐tion and diagnosis and treatment operation confusion accounted for 97 .01% ,the knowledge and technology of microbiological exam‐ination was relatively low .Conclusion Basic data of hospital infection monitoring and quality control survey can understand the sit‐uation of hospital infection management ,it can help to improve the monitoring level of nosocomial infection by investigating the weak links and strengthening the intervention .

Objective To explore the rehabilitation outcome and influencing factors of functional recovery in patients with nontraumatic spinal cord injury (NTSCI). Methods A retrospective analysis was done on 49 cases suffering from NTSCI who recepted rehabilitation therapy from December 2014 to November 2016. The main indicator of the rehabilitation effect was Modified Barthel Index (MBI). A total of 49 cases were divided into two groups, effective group (31 cases) and ineffective group (18 cases) according to whether their MBI on discharge had beated the target setted on admission. The following factors:ages, gender, injury causes, injury level, injury grade, injury severity, the types of paralysis, hospitalization time, sick time, complications number, MBI on admission and discharge, operation, early rehabilitation were evaluated by Univarite analysis and Logistic stepwise regression to assess how they influenced rehabilitation outcome. Results After systematically rehabilitation training, MBI had apparent improvement, from (38.98 ± 24.90) score on admission to (56.35 ± 22.69) score on discharge and had statistical significance(Z=-4.95, P=0.00), which showed that rehabilitation training can effectively improve patients′ self-care ability of daily living. Regression analysis found that the MBI on admission (OR=1.044, P=0.010) and hospitalization time(OR=1.044, P=0.039) had a noticeable effect on the rehabilitation outcome, while all the other factors, such as age, sex, injury grade, injury level, injury severity, complications number hadn′t show concrete effect on rehabilitation outcome. Conclusions Patients with NTSCI should have early rehabilitation, medical staff should assess their admission MBI, make a strict rehabilitation training plan to improve rehabilitation efficiency, shorten hospitalization time, improve the patients quality of life.