Objective To investigate the risks and benefits of interventions promoting placental transfusion (PT) at delivery [delayed cord clamping (DCC) or umbilical cord milking (UCM)] compared with early cord clamping (ECC) on outcomes among very low birth weight infants (VLBWI).Methods A systematic search was conducted of PubMed, EMBASE, ClinicalTrials.gov, China Academic Journal Network Publishing Database and Wanfang Medical Databases (January 1965 to July 2014) for randomized controlled trial (RCT) articles relating to PT strategies (DCC and UCM) in VLBWI.The Cochrane Handbook 5.1.0 was used to evaluate the methodological quality and RevMan 5.3 software from Cochrane Collaboration was used for metaanalysis.The fixed effect or random effect model was adopted according to the result of heterogeneity, Results We identified 14 eligible studies describing a total of 659 neonates with an average birth weight ＜ 1 500 g.There were eight studies for DCC and six studies for UCM.Compared with the control, benefits of greater PT decreased any grade intraventricular hemorrhage (IVH) (nine studies, OR=0.49, 95％CI: 0.32-0.77, P ＜ 0.01), increased the blood pressure at four hours of life (eight studies, MD=4.42, 95％CI: 3.85-4.98, P ＜ 0.01), and also showed higher initial hemoglobin (Hb) level (six studies, MD=3.52, 95％CI: 1.67-5.37, P ＜ 0.01) and lower incidence of sepsis during the hospital stay (five studies, OR=0.46, 95％CI: 0.26-0.83, P=0.01).No differences were observed between the groups about the fllowing indicators (all P ＞ 0.05): 5-minute Apgar scores (MD=0.01,95％CI:-0.21-0.22), admission temperature (MD=0.13, 95％CI:-0.15 to 0.41), peak serum bilirubin levels (MD=0.59, 95％CI:-0.13 to 1.31), initial reported hematocrit (MD=3.48, 95％CI:-0.46 to 7.43), mortality before discharge (OR=0.63, 95％CI:0.31-1.25), Bell's stage 2 or greater necrotizing enterocolitis (OR=0.62 ,95％CI: 0.29-1.33), rates of transfusion due to anemia (OR=0.63, 95％CI: 0.35-1.15) and oxygen therapy at 36 weeks of corrected age (OR=0.79, 95％CI: 0.46-1.34).Conclusions It is suggested that enhanced PT (both DCC and UCM) at birth is safe and provide better neonatal outcomes than ECC for those VLBWI, most notably reduces the overall IVH occurrence and lower the incidence of sepsis.The optimal umbilical cord clamping practice and UCM among VLBWI infants remains uncertain and long-term neurodevelopmental outcomes are warranted.

OBJECTIVE To enhance the rational usage of antimicrobial agents in hospitalized patients by comprehensive interventional measures in clinics.METHODS The selected indictors recommended by WHO were applied to evaluate the use of antimicrobial agents in hospitalized patients.The hospital information was gained from hospital administration section.The prescription and treatment data were collected from the discharged patients′ medical history.Intervention was involved in managerial and educational strategies.RESULTS After intervention,the average number of antimicrobial agents prescribed per inpatient fell from 2.13 to 1.97.The average cost of antimicrobial agents prescribed per inpatient fell from 1765.23 yuan to 1136.18 yuan(P

Objective To investigate clinical distribution and drug sensitivity of infectious pathogens in our wards for hematology malignancies. Methods Drug sensitivity tests of bacteria were performed by Kirby-Bauer method, 56 strains of pathogens were isolated from all detected samples. Results The results showed that the composition ratio of Gram-negtive bacteria, Gram-positive bacteria was 69.64%, 30.36%. In decreasing frequency, Escherichia coli (37.50%), Klebsiella pneumoniae (10.71%). All of staphylococcies were resistant to meticillin, and sensitive to vancomycin. Conclusion This study indicates that Gramnegative bacteria remain the predominant pathogens in microorganisms causing bloodstream infections for hematological malignancies at Huashan Hospital. The incidence of Escherichia coli is the highest. All of staphylococcies were resistant to meticillin.

Objective:To investigate reperfusion and secondary preventive drug therapy for ST-segment elevation myocardial infarction (STEMI) patients in provincial, city and county levels hospitals of China.
Methods:A total of 18,967 STEMI patients within 7 days of symptom onset from 2013-01-01 to 2014-09-30 were enrolled by China acute myocardial infarction (CAMI) registry study group from 107 hospitals covering 31 provinces/autonomous regions, cities and counties in China;223 patients were excluded for key information missing. Demographic data, reperfusion as primary percutaneous coronary intervention (pPCI), thrombolytic therapy (TT) and secondary preventive drug therapy as aspirin, P2Y12 inhibitors, statins,β-blockers, angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor antagonist (ARB) were analyzed and compared among 3 levels of hospitals.
Results:There were 9,885/18,744 (52.7%) patients received reperfusion including 8,038 (42.9%) pPCI and 1,847 (9.9%) TT. Reperfusion rate in provincial hospital (61.8%, 4041/6537) was higher than city hospital (49.1%, 4728/9625) and county hospital (43.2%, 1116/2582), P<0.001;reperfusion type was distinctive among 3 levels of hospitals, for provincial hospital:pPCI was performed in 3,840 (58.7%), TT in 201(3.07%) patients;for city hospital:pPCI in 3,753 (39.0%), TT in 975 (10.1%) patients;for county hospital:pPCI in 445 (17.2%), TT in 671 (26.0%) patients. 12,502 patients arrived hospital within 12 h of symptom onset and 8,835 (70.8%) of them received reperfusion including 7089 (56.7%) patients with pPCI and 1,746 (14.1%) with TT. 3537 (80%) patients received reperfusion in provincial hospital, 4272 (67.5%) in city hospital and 1045 (59.8%) in county hospital, P<0.001.The in-hospital application of statins was in 16,575 (90.9%) patients, aspirin was 17,963 (96.8%), P2Y12 inhibitors was 17,922 (96.5%),β-blockers was 12,657 (68.2%) and ACEI/ARB was 10,541 (56.8%) respectively;the therapeutic condition was similar among 3 levels of hospitals.
Conclusion:In CAMI Registry, 70.8%arrived hospital within12 h of symptom onset had been treated by reperfusion therapy in China; the reperfusion rate in county hospital was obviously lower. The secondary preventive drug therapy condition was similar among 3 levels of hospitals.

Objective To explore the application effect of Interactive continuing nursing intervention model with three subjects and two tracks,which is based on internet and applied to chronic heart failure patients.Methods During January 1 to December 30,2017,110 chronic heart failure patients,who were going to discharge from the Second People's Hospital of Guangdong Province,were selected for this research.Participants were equally divided into control group and observation group with random number table with 55 cases each.Participants were adopted conventional medication and traditional care,while patients in control group were given extra interactive continuing nursing intervention with three subjects and two tracks,which was relied on internet-based cardiovascular disease management platform.Comparing patients' scores of life quality,self-care ability,anxiety and depression degree before intervention and that in 6 months after intervention with Minnesota Living with Heart Failure Questionnaire (MLHFQ),Self Care of Heart Failure Index (SCHFI),Self-rating Anxiety Scale(SAS)and Hamilton Depression Scale (HAMD) respectively.Moreover,6 minute walk test was conducted,simultaneously,the incidence of cardiovascular events was calculated respectively before intervention,3 months after intervention and 6 months after intervention.Results It showed that total scores of MLHFQ,SCHFI,SAS and HAMD for patients in observation group before intervention were (49.05 ± 4.39),(101.57 ±21.04),(58.3 ± 5.2) and (40.1 ± 3.5) points respectively while that for patients in observation group after 6 months intervention were (43.03 ± 6.85),(123.17 ± 18.23),(42.3 ± 4.2) and (24.4 ± 4.3) points respectively.The difference was statistically significant (t =5.49-20.60,all P ＜0.01).In comparison,intervention effect of observation group was better than that of control group,although,the SAS scores of the control group were statistically significant.Furthermore,after intervention,the difference of MLHFQ,SCHFI,SAS and HAMD scores were statistically significant(t =3.48-17.79,all P ＜0.01).Moreover,6 months after intervention,6 minute walk test evaluation showed that there was statistical significance between observation group and control group (~=8.11,P ＜0.05).Besides,The death rate in observation group was lower than that in control group after 6 months intervention (~=6.30,P ＜0.05).Meanwhile,readmission rate after 3 months and 6 months indicates that there was statistical significance between observation group and control group(x2=5.25,6.30,P ＜0.05).Conclusions Interactive nursing intervention model with three subjects and two tracks which based on internet is able to enhance chronic heart failure patients' self-care ability and life quality,decrease the incidence of cardiovascular events and negative emotion of patients.