Objective To study the occurrence,risk factors,and direct economic losses caused by healthcare-asso-ciated infection(HAI)in hemodialysis patients in a hospital.Methods 840 patients who underwent hemodialysis in this hospital from April 2012 to September 2014 were selected,incidence of HAI,related factors,and economic los-ses due to HAI were investigated.Results Among 840 hemodialysis patients,89 patients developed 104 times of HAI,HAI density was 4.27‰ . Multivariate regression analysis showed that young age and old age,combined mul-tiple diseases,long duration of hemodialysis,two or more intubation sites,prolonged intubation,long length of hospital stay were all risk factors for HAI(OR= 1.123-2.325);Fees for bed,consultation,examination,treat-ment,nursing,medicine,and others in HAI group were all significantly higher than non-infected group(H= 49.6-1 038.9,all P<0.01 ),difference in medicine fees was most significant.Conclusion Risk factors for HAI are young age and old age,combined multiple diseases,long duration of hemodialysis,two or more intubation sites, prolonged intubation,and long length of hospital stay,the occurrence of HAI can increase the economic burden of hemodialysis patients.

OBJECTIVE To study the bactericidal efficacy of glutaraldehyde,and its stability and change in pH value.METHODS The carrier quantity bactericidal test,field mimic bactericidal test,stability test,pH value detection,periodical biological surveillance and follow-up investigation of hospital infection were used.RESULTS After using of 20 000 mg/L of neutral glutaraldehyde on Candida albicans(ATCC 10231),Pseudomonas aeruginosa(ATCC27853),Escherichia coli(ATCC 25922) and other 3 clinical isolates separately for 3,5,and 10 min,the average killing rate was 97.90%,99.83% and 100.00%;on the field mimic bactericidal test with MRSA contaminated gastroscope,the average killing rate was 87.84%,99.50%,and 100.00%,respectively.The concentration of disinfectant after storaging 14d on 54℃ was decreased,only loss 1.46%,the concentration loss of disinfectant on using endoscope 5,7,and 14d after disinfection was 2.64%,0.69% and 0.94%,respectively.The value of pH was decreased from 7.22 to 6.00,6.50,and 6.20.The qualification rate of 260 various endoscopes after surveillance was 100.00%.Their was one of hospital infection happened among 3 200 patients after endoscopy which were followed up.CONCLUSIONS The results show that,only under the following circumstances,namely the concentration of glutaraldehyde being no less than 20 000mg/L and the action time being no less than 10 min,timely alteration of glutaraldehyde,and regular biological and concentration monitoring could the disinfection of endoscope be qualified so that hospital infection can be prevented,and medical dispute may be put to an end.

OBJECTIVE To know the disinfection efficacy of electrolyzed oxidizing water(EOW) and glutaraldehyde on clinical used gastroscope and enteroscope in our hospital and to analyze their stability and probable harm.METHODS The gastroscope and enteroscope before and after use on randomly selected outpatients and inpatients were examined on their contamination,and the efficacy of EOW was compared with that of glutaraldehyde.RESULTS After using EOW and glutaraldehyde to disinfect the gastroscope and enteroscope the former showed that its killing rate on commonly encountered pathogens for 1 min was 93.75-98.22%,for 3 min was 81.20-89.29%,and for 5 min was 100.00%;the latter showed that its killing rate for 3 min was 81.20-89.29%,for 5 min was 90.38-93.04%,and for 10 min was 99.92-99.96%.EOW was non-irritative to mucosa,and didn′t cause allergic reaction,but its stability was poor.The glutaraldehyle could bring some side effects,such as some allergy,and mucosa stimulation.CONCLUSIONS It only needs 3-5 min for EOW to kill polluted bacteria on gastroscope and enteroscope to attain the disinfection eligibility,but glutaraldehyde needs more than 10 min to get to the disinfection eligibility.The effect of EOW is strong,rapid,active and environment-safe,it is worthy of application,but it must be applied immediately as soon as possible after production.The use of glutaraldehyde must strengthen the measures of personal protection.

Objective To investigate the myocardial injury effects of intrathecal morphine injection in elderly patients undergoing thoracoscopic lobectomy.Methods Fifty-five elderly patients undergoing elective thoracoscopic lobectomy,28 males and 27 females,aged 65-85 years,BMI 18.5-27.9 kg/m2,ASA physical status Ⅰ or Ⅱ,were divided into two groups using the digital random allocation method:the control group(group C,n=28)and intrathecal morphine group(group M,n=27).Group M was given a single injection of morphine 4 pig/kg in the L2-3 space before surgery.General anesthesia was used in both groups,and single-lung ventilation was performed with double-lumen endotracheal intubation.Venous blood was collected before induction,24 and 48 hours after the operation to measure the levels of N-terminal brain natriuretic peptide precursor(NT-proBNP),creatine kinase isoenzyme(CK-MB),high-sensitivity troponin T(hs-TnT)and C-reactive protein(CRP).The incidence of myocardial injury after noncardiac surgery(MINS)was recorded.The intraoperative remifentanil dosage was recorded and the VAS pain scores at rest and during activity at 6,12,24,and 48 hours postoperatively were evaluated.The number of effective pa-tient-controlled intravenous analgesia(PCIA)compressions,the total number of PCIA compressions,the times of remedial analgesia in the postoperative period of 48 hours,as well as the incidence of postoperative adverse reactions(respiratory depression,nausea and vomiting,urinary retention,and pruritus)were re-corded.Postoperative 30-day major adverse cardiovascular and cerebrovascular events were recorded.Results Compared with preoperative,the levels of serum NT-proBNP,CK-MB,hs-TnT,and CRP were significantly higher in both groups at 24 and 48 hours postoperatively(P＜0.05).Compared with group C,the elevated levels of serum NT-proBNP,CK-MB,hs-TnT,CRP,and absolute hsTnT changes were signifi-cantly lower in group M 24 and 48 hours after operation(P＜0.05),the incidence of MINS was signifi-cantly lower in group M(P＜0.05).Compared with group C,the VAS pain scores of patients in group M were decreased significantly 6,12 and 24 hours during activity and 12 and 24 hours at rest after surgery(P＜0.05),the dosage of intraoperative remifentanil,the number of effective and total postoperative PCIA compressions,and the incidence of need for postoperative remedial analgesia were significantly reduced in group M(P＜0.05).There was no significantly difference in the incidence of postoperative adiverse reca-tions between the two groups.Conclusion Intrathecal morphine can reduce the levels of markers of myo-cardial injury in elderly patients undergoing thoracoscopic lobectomy,which plays a partial role in myocardial protection.