Objective To investigate the hand washing state and its influencing factors in patients undergoing infusion in outpatient clinic in order to adopt measures to enhance the patients' consciousness of hand hygiene. Methods 300 adult patients undergoing infusion in outpatient clinic were investigated.The bacteria condition before and after washing hands was observed. The condition and washing apparatus in the infusion room were also evaluated. Results The bacteria amount in the hands of patients undergoing infusion was 20 to 36 times higher than the standard level. The washing apparatus was simple and did not reach the standard requirement. Conclusion We should strengthen the propaganda of hand hygiene knowledge to patients undergoing infusion and improve their recognition of the importance of hand washing. The hospital should improve the washing facilities to reduce hospital infeciton.

Objective Comparison of the levator ani muscles in three-dimensional (3D) MRI-based models in women with and without pelvic organ prolapse at rest to analyze the morphological characteristics of levator ani muscles in women with POP. Methods Twenty-five women with POP and 22 women with normal pelvic support were selected from Nanfang Hospital of Southern Medical University. Axial, sagittal, and coronal T2-weighted pelvic magnetic resonance scans were obtained with the women in the supine position.The 3D models were reconstructed from the source images. Morphological changes was compared within the two groups of levator ani muscles, and the 3D models were measured to determine the levator ani muscle volume (LVOL), levator plate angle (LPA), levator hiatus width (LH-W) and length (LH-L), distance between symphysis and levator sling muscle (LSG). Results There were no puborectalis avulsions in control, in POP, 3 cases of avulsions just in left, 3 cases of avulsions just in right, 7 cases in bilateral. The shape of iliococcygeus were all dome-shaped in control, 11 cases were U-shaped and 14 cases were dome-shaped in POP. The shape of levator hiatus were 7 cases of U-shape, 12 cases of V-shape, 3 cases of irregular in control; 5 cases of U-shape, 4 cases of V-shape, 16 cases of irregular in POP. POP versus control: LH-L: (68.0 ± 8.9) versus (61.6 ± 7.2) mm (P<0.05); LH-W: (41.4 ± 3.9) versus (38.0 ± 3.2) mm (P<0.05); LSG-L: (29.6 ± 7.4) versus (24.6 ± 3.7) mm (P<0.05); LSG-R: (28.4 ± 6.8) versus (23.9 ± 3.2) mm (P<0.05); LPA: (51.0 ± 11.3)° versus (40.6 ± 6.3)° (P<0.05); LVOL: (23.7 ± 5.8) versus (24.6 ± 5.0) cm3 (P>0.05). Conclusions It is possible to assess the morphologic changes of levator ani by using 3D MRI models objectively, our 3D data demonstrate larger in LVOL, LPA, LH-W, LH-L, LSG, and the changes in shape. It is helpful to diagnose and assess the specific situation of patients POP in clinic.

【Objective】 To study the changes in erythrocyte osmotic fragility(EOF) in patients with hypercythemia, polycythemia and anemia under a high altitude environment. 【Methods】 A total of 174 outpatients, inpatients and people undergoing physical examination in Tibet Autonomous Region People′s Hospital in October 2020 were enrolled and divided into four groups according to hemoglobin levels: the polycythemia group(n=42), the physiologic increase group(n=48), the anemia group(n=29) and the healthy control group(n=55). They were compared with 67 anemia patients and 67 healthy people in the laboratory of Peking Union Medical College Hospital in the same period as the plain control group. The classic EOF test method was used to compare the results of each group′s EOF. The concentrations of NaCl solution for starting hemolysis (STH) and NaCl solution for complete hemolysis (CTH) were included, and the data were statistically analyzed by SPSS software. 【Results】 There was a significant difference in CTH between Zang and Han healthy people (P<0.05). STH in high altitude polycythemia group(0.52) was higher than that in high altitude healthy control group(0.48) (P<0.001). Compared with plain, the median CTH of plateau anemia group(0.36) and plateau health control group(0.36) was significantly higher than that of plain anemia group(0.28) and plain control group(0.28) (P<0.001). Multivariate logistic regression analysis showed that plateau region, female polycythemia and anemia were risk factors for STH elevation. 【Conclusion】 This study finds that the EOF increases in the plateau population and patients with polycythemia, which provides reference for studying red blood cell disorders and blood transfusion strategy in the plateau region.