OBJECTIVETo investigate the incidence of needlestick and sharps injuries among the medical staff in an upper first-class hospital and its risk factors and to provide a basis for the infection control department of hospital and health administration department to establish the policies for safe injection.

METHODSA questionnaire survey was conducted in 800 healthcare professionals in an upper first-class hospital in Nanjing, China to investigate the incidence of needlestick and sharps injuries in the past year. A total of 641 persons completed the questionnaire, including 239 doctors, 348 nurses, and 54 other healthcare workers. The obtained data were subjected to chi-square test and logistic analysis.

RESULTSNeedlestick and sharps injuries occurred in 373 of 641 healthcare professionals, with an incidence rate of 58.19%. There were significant differences in the incidence of needlestick and sharps injuries among the medical staff of different types or in different departments (P < 0.01). The syringe needles, glass, scalp infusion needles, and suture needles were the major medical apparatus that caused needlestick and sharps injuries; the incidence rate of injury caused by suture needles in doctors (48.21%) was significantly higher than that in nurses (6.72%) (P < 0.01), and the incidence rates of injuries caused by syringe needles, scalp infusion needles, and glass in nurses (71.15%, 59.68%, and 49.04%) were significantly higher than those in doctors (46.43%, 6.25%, and 16.96%) (P < 0.01); compared with nurses, the doctors had higher incidence rates of injuries due to body fluid or tissue sample collection, wound flushing, suture, and cutting (P < 0.05); compared with doctors, the nurses had higher incidence rates of injuries due to injection, intravenous infusion, heparin cap sealing, intravenous infusion line connection, and venous or arterial blood collection (P < 0.05).

CONCLUSIONNeedlestick and sharps injuries are common in medical staff. The results of the study on risk factors provide a basis for the infection control department of hospital and health administration department to establish the policies for safe injection.

Accidents, Occupational ; statistics & numerical data ; China ; Female ; Health Personnel ; Humans ; Incidence ; Male ; Needlestick Injuries ; epidemiology ; Risk Factors ; Surveys and Questionnaires

Objective: To understand sleep behavior among primary and middle school students and its impact on overweight and obesity changes, to provide evidence for developing obesity prevention and controlling strategies in children and adolescents. Methods: Primary and middle school students from three cities in Zhejiang Province who participated in questionnaire surveys and physical measurements in both 2017 and 2019 were selected. A follow up dataset of 605 students was developed and the relationship between sleep duration and body mass index was analyzed. Results: From 2017 to 2019, BMI Z scores for male and female participants increased by 0.24 and 0.13, respectively. BMI Z scores increased by 0.29 in students of 9-12 years old and increased by 0.11 and 0.25 in urban and rural students, respectively ( P <0.05). The prevalence of insufficient sleep duration increased from 37.0 % to 41.8% simultaneously ( χ 2=3.68, P =0.06). After adjusting for confounding factors, the BMI Z score of students with insufficient sleep was 0.20 higher than those with sufficient sleep duration ( P <0.01). Compared with participants who had sufficient sleep duration from 2017 to 2019, participants whose sleep duration changed from sufficient to insufficient, and those who always had insufficient sleep duration increased by 0.23, respectively ( P <0.05). Conclusion Insufficient sleep duration is a risk factor for obesity. Shortened sleep duration is related to weight gain, and maintaining sufficient sleep duration may reduce the risk of obesity in children and adolescents.

OBJECTIVEEpinephrine has a place in the treatment of pediatric cardiopulmonary arrest but has been controversy concerning its optimal dose. This meta-analysis aimed to seek for evidences of the effectiveness of different doses of epinephrine in children with cardiac arrest and to evaluate the effectiveness of high-dose versus standard-dose epinephrine in children with cardiac arrest.

METHODPublished papers on randomized controlled trials (RCTs) and prospective clinical controlled trials (CCTs) were electronically searched from MEDLINE (1966 to September 2006), EMBASE (1974 to June 2006), the Cochrane Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2006), CBM (1998 to 2006) and CNKI (1994 to 2006). We also had searched the related references and manual retrieval 10 professional academic journals about epinephrine treatment of pediatric cardiopulmonary arrest (1998 to 2006). The search strategy was made according to the collaborative review group search strategy. At first, we found 546 articles. Second, we excluded 474 of them through reading the title, abstract, excluding non-randomized, non-controlled trials and non-clinical studies. Finally, we identified 4 papers through searching for original articles and telephone contact with some of the authors after excluding 68 papers. Then we performed the meta-analysis by RevMan 4.2.7. For homogenous dichotomous data (P > or = 0.1, I(2) < or = 50%) we calculated fixed effects model, relative risk (RR), 95% confidence intervals (CI), For heterogeneity Dichotomous data (P < 0.1, I(2)>50%) we calculated random effects model, relative risk (RR) and 95% confidence intervals (CI).

RESULTFour trials involving 360 cases were included. The results of meta-analysis indicated that there were no statistical difference in recovery of spontaneous circulation [RR = 1.28, 95% CI (0.93, 1.77)]. Perondi, Patterson and Cheng xiuyong's study compared the rate of survival at 24 hours and showed statistical heterogeneity (P = 0.01, I(2) = 0.77). The random effects model indicated that there were no significant difference [RR = 1.40, 95% CI (0.43, 4.55)]. The sensitivity analysis showed that after deleting Perondi's group there were no statistical heterogeneity. Fixed effects model indicated that there were significant difference [RR = 2.50, 95% CI (1.52, 4.11)]. T When the rates of survival to hospital discharge were compared among the 4 studies, there was statistical heterogeneity (P = 0.07, I(2) = 0.58), the random effects model indicated that there were no statistical difference [RR = 1.78, 95% CI (0.42, 7.50)], There were no heterogeneity after Cheng Xiu-yong group was deleted.

CONCLUSIONHigher doses of epinephrine in children with cardiopulmonary arrest may not increase the rate of recovery of spontaneous circulation, the rate of survival at 24 hours, the rate of survival to hospital discharge and worsen the neurological outcomes. Adverse reactions is difficult to monitor and evaluate because of the current restrictions on medical technology.

Bronchodilator Agents ; toxicity ; Child ; Epinephrine ; toxicity ; Heart Arrest ; chemically induced ; mortality ; Humans ; Pediatrics ; Risk ; Treatment Outcome ; United States

OBJECTIVETo observe effects of wrist-ankle acupuncture on functional states of the vegetative nerve in the recruit.

METHODSSixty recruits with the vegetative nerve balance index y > +0.56 determined with "Wenger-Chong Zhong Zhong Xiong"'s vegetative nerve balance factor assay were randomly divided into a treatment group and a control group. The treatment group were treated with wrist-ankle acupuncture and the control group with nothing.

RESULTSAfter treatment, 24 cases with y < +0.56 was found in the treatment group and 16 cases in the control group with a significant difference between the two groups (P < 0.05).

CONCLUSIONWrist-ankle acupuncture can better improve functional state of the vegetative nerve in the recruit.

Acupuncture Therapy ; Ankle ; Ankle Joint ; Humans ; Nerve Tissue ; Wrist

OBJECTIVETo investigate the effect of multi-plane Hyaluronic acid (HA) injection for rhinoplasty.

METHODSThe HA was injected below or above the periosteum at the nasal bone, above the perichondrium at the cartilage portion of nose, and between the great alar cartilage at the nasal tip. The HA volume was 1-1.5 ml, according to the nose form and aesthetic assessment. Over-injection was not permitted. Touch-up injection could be performed one week after the first injection if need.

RESULTSFrom Jan. 2010 to Jan. 2012, 60 cases underwent rhinoplasty with HA injection. The patients were followed up for 10-13 months with satisfactory result. The effect lasted about 9 months with the longest period as 12 months and the shortest period as 6 months.

CONCLUSIONSGood results can be achieved with multi-plane HA injection for rhinoplasty.

Adult ; Female ; Follow-Up Studies ; Humans ; Hyaluronic Acid ; administration & dosage ; therapeutic use ; Injections ; Male ; Rhinoplasty ; methods ; Treatment Outcome ; Young Adult

Objective To explore the association between the different forms of in vivo ghrelin—Acyl ghrelin( AG) ,Des-acyl ghrelin( DAG) and AG/DAG with insulin resistance( IR) in patients with type 2 diabetes mellitus. Methods From June 2017 to November 2017,eighty-three patients with type 2 diabetes hospitalized in (group T2DM) and 40 healthy subjects (group NC) were hospitalized in Jinling Clinical Medicine were selected. Height body mass,blood pressure,blood lipid,glycated hemoglobin ( HbA1c) and fasting blood glucose (FPG),fasting insulin (FINS),and fasting C peptide (F-C-p) were measured,and all subjects were left with fasting serum,and the concentration of AG and DAG were measured by enzyme linked immunosorbent assay (ELISA). The body mass index (BMI),total gastric starvation (T-ghrelin) level,AG/DAG,insulin resistance index ( HOMA-IR) , insulin sensitivity index ( HOMA-IS ) and islet beta cell function ( HOMA- beta ) were calculated. The differences of the above indexes between the two groups were compared, and the relationship between AG,DAG,T-ghrelin,AG/DAG and FPG,HOMA-IR,HOMA-IS and HOMA- beta in T2DM patients were analyzed. Results ( 1) There were no significant difference in SBP、DBP、TC、LDL-C、AG between group NC and group T2DM(P>0. 05). Compared with NC group,the age、TG、BMI、HbA1c、FPG、FINS、HOMA-IR、HOMA-β、AG/DAG were significantly higher in T2DM group ( t=2. 690,-1. 990, 0. 873, 14. 257, 10. 528, Z=2. 885,-3. 483,-2. 284;P<0. 01,P<0. 05) . The HDL-C,F-C-p,HOMA-IS,HOMA-beta,DAG and T-ghrelin in group T2DM were lower than those of NC group( t or Z=0. 477,-3. 812,-3. 395,-4. 4,-2. 916,-2. 834;P<0. 05 or P<0. 01) . ( 2) The correlation analysis showed that there was a positive correlation between AG and FPG in T2DM group (r=0. 252,P<0. 05),DAG and T-ghrelin were negatively correlated with HOMA-IR (r=-0. 394,-0. 384,P<0. 05),and AG/DAG was positively correlated with HOMA-IR (r=0. 394,0. 384,P<0. 05),but is negatively correlated with HOMA-IS (r=-0. 292,P<0. 05). (3) multivariate linear regression analysis showed that FPG in T2DM patients were the influencing factors of AG ( t=2. 865,P<0. 05) ,while FINS and BMI were the influencing factors of DAG( t=-2. 808、-0. 330,P<0. 05) andT-ghrelin( t=-2. 725、-0. 330, P<0. 05) . HOMA-IR and BMI are the influencing factors of AG/DAG ( t=3. 718,3. 069,P<0. 05) . Conclusion The levels of DAG and T-ghrelin in group T2DM were significantly lower than those in the normal population, and was negatively correlated with the insulin resistance index,and the ratio of AG/DAG was closely related to insulin resistance,and the level of AG was mainly affected by fasting blood glucose.

OBJECTIVETo assess the effect of delayed opening of the infarct-related artery (IRA) by percutaneous coronary intervention (PCI) on the late left ventricular remodeling after acute anterior myocardial infarction (AAMI).

METHODSSixty four patients with initial Q-wave AAMI and with the total occluded IRA conformed by angiogram at 9.1 +/- 2.3 (2 - 14) days after the onset were divided into successful PCI group and control group (not receiving PCI or the IRA not re-opened). Two-D echocardiogram was performed at acute phase (about 3 weeks), 2 and 6 months after onset of AAMI respectively to detect the left ventricular function and left ventricular wall motion abnormality (VWMA). The total congestive heart failure events were recorded during 6 months follow-up.

RESULTSVWMA scores, left ventricular ejection fraction (LVEF), left ventricular end-diastolic and end-systolic volume indexes (LVEDVI and LVESVI) were similar in 2 groups at acute phase and 2 months after the onset of AAMI. There were no differences between the parameters above at acute phase and 2 months in each group too. VWMA scores and LVEF did not changed significantly at 6 months in each group compared with those at acute phase and 2 months (P > 0.05). But LVEDVI and LVESVI were significantly smaller in the successful PCI group than those in the control group (P < 0.01, P < 0.05). The rate of congestive heart failure events was 19% in control group and 2.0% in successful PCI group (P > 0.05) respectively.

CONCLUSIONSDelayed opening of IRA in AAMI could prevent the late phase but not the early phase of left ventricular remodeling after AMI.

Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; pathology ; physiopathology ; therapy ; Myocardial Reperfusion ; Ventricular Remodeling

OBJECTIVETo investigate the clinical application of diffusion weighted imaging (DWI) in uterine cervical cancer and the apparent diffusion coefficient (ADC) value in diagnosis and predicting treatment response.

METHODSTwenty-eight patients with advanced primary cervical cancer confirmed by pathology and 10 cases of normal uterine cervix as control were recruited in this prospective clinical trial. To analyze the correlation between tumor volume measured in DWI and tumor maximum diameter measured according to the RECIST criteria. To compare the ADC value differences among the uterine cervical cancer, uterine myometrium, and normal uterine cervix. To compare the ADC values in 17 cancer patients before and after treatment.

RESULTSThe illustration of tumor boundary in DWI was superior to conventional T2WI and post-enhancement T1WI. The DWI with higher b value (2000 s/mm(2)) had a better signal-to-noise ratio. The tumor volume measured in DWI has good correlation with tumor maximum diameter according to RECIST criteria (r = 0.759, P < 0.01). When b = 800 s/mm(2), the ADC values of the uterine cervical cancer, uterine myometrium, and normal uterine cervix were (9.85 ± 1.55)×10(-3) mm(2)/s, (14.20 ± 2.80)×10(-3) mm(2)/s, and (14.14 ± 0.45) ×10(-3) mm(2)/s. When b = 2000 s/mm(2), the ADC values of the uterine cervical cancer, uterine myometrium and normal uterine cervix were (7.38 ± 0.98)×10(-3) mm(2)/s, (8.52 ± 2.38)×10(-3) mm(2)/s, and (8.60 ± 0.63)×10(-3) mm(2)/s, respectively. There were significant differences between the cervical cancer and normal cervix or uterine myometrium (P < 0.001 for both). When b = 800 s/mm(2), the ADC value was (9.85 ± 1.55)×110(-3) mm(2)/s before and (13.41 ± 2.93)×10(-3) mm(2)/s after treatment (P < 0.001). When b = 2000 s/mm(2), the ADC value was (7.38 ± 0.98)×10(-3) mm(2)/s before and (8.93 ± 1.92)×10(-3) mm(2)/s after treatment (P = 0.008). Univariate logistic regression analysis showed that 25% ADC, 50%ADC, and 75%ADC in the tumor ADC value histogram before treatment were significantly correlated to the treatment outcome of cervical cancer (P < 0.05 for all). Multivariate regression analysis showed that 25%ADC, 50%ADC, and 75%ADC in the tumor ADC value histogram before treatment were not significantly correlated to the treatment outcome of cervical cancer (P > 0.05 for all). The values of ROC curves were 25%ADC = 0.818, 50%ADC = 0.775, and 75%ADC = 0.716 (P > 0.05), however, the 25% ADC showed a relatively stronger statistical power.

CONCLUSIONSDWI helps to confirm the morphology and exact target zone of the tumor for radiotherapy. DWI volume measurement is well correlated with RECIST criteria, particularly in volume measurement of irregular tumors. ADC value has a potential in quantitatively monitoring treatment response and predicting outcome of cervical cancers.

Adenocarcinoma ; diagnosis ; drug therapy ; pathology ; radiotherapy ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Squamous Cell ; diagnosis ; drug therapy ; pathology ; radiotherapy ; Case-Control Studies ; Cervix Uteri ; pathology ; Cisplatin ; therapeutic use ; Diffusion Magnetic Resonance Imaging ; Female ; Humans ; Middle Aged ; Myometrium ; pathology ; Prospective Studies ; ROC Curve ; Radiotherapy, Conformal ; Treatment Outcome ; Tumor Burden ; Uterine Cervical Neoplasms ; diagnosis ; drug therapy ; pathology ; radiotherapy

OBJECTIVETo compare the outcomes of intracytoplasmic sperm injection (ICSI) with retrieved epididymal and testicular sperm for obstructive azoospermia and with ejaculated sperm for severe oligozoospermia and asthenospermia.

METHODSWe retrospectively analyzed 431 ICSI cycles, which were divided according to sperm sources into Groups A (n=287 in patients with severe oligozoospermia or asthenospermia using ejaculated sperm), B (n=109 in obstructive azoospermia patients with sperm retrieved by percutaneous epididymal sperm aspiration, PESA) and C (n=35 in obstructive azoospermia patients with sperm retrieved by testicular sperm extraction, TESE). Comparisons were made among the three groups in the rates of embryo implantation, fertilization, pregnancy, cleavage, and miscarriage.

RESULTSGroup A showed statistically significant differences from Groups B and C in the rates of embryo implantation and pregnancy (18.46% vs. 25.23% and 28.76%, 31.23% vs. 42.16% and 39.39%, P < 0.05). But no significant differences were seen in the rates of fertilization, cleavage and miscarriage among the three groups (P > 0.05).

CONCLUSIONThe rates of embryo implantation and clinical pregnancy are higher in patients with obstructive azoospermia than in those with severe oligozoospermia or asthenospermia after ICSI with ejaculated sperm.

Azoospermia ; therapy ; Epididymis ; cytology ; physiopathology ; Female ; Humans ; Male ; Oligospermia ; therapy ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; methods ; Spermatozoa ; Testis ; cytology ; physiopathology

Objective:To study the distribution and related factors of aggressive behavior among school aged children in Nanjing.Methods:Totally 4678 primary school students in Nanjing were sampled by cluster random sampling in this study.The General questionnaire and Achenbach's child Behavior Checklist were used to investi gate the general situation and aggressive behavior.Results:The rate of aggressive behavior of school-age children in Nanjing was 3.6 ％ (167/4678).Multivariate logistic regression analysis indicated that democratic parenting style [other parenting styles (OR =1.94,95％ CI =1.10-3.42),mixed parenting style(OR =1.96,95％ CI =1.35-2.85)],and genetic screening before birth (OR =0.71,95％ CI =0.52-0.99) were protective factors for children's aggressive behavior.The factor figures of aggressive behavior were positively correlated with that of oth er behavior problems in Pearson correlation analysis (r =0.52-0.80,Ps ＜0.01).Conclusion:About 3.6％ of the school aged children in Nanjing have aggressive behavior.It is more likely to have aggressive behaviors for children who is in other parenting styles except the democratic style and never have the genetic screening before birth.And children who with aggressive behavior may co-occur with other behavior problems.