This paper reports a case of female patient with throat discomfort and coughs for several months. She was discovered by laryngoscopy with a pale yellow lump in the left aryepiglottic fold and pyriformin with the size of 2.0 cm x 1.6 cm. MRI fat suppression sequence exhibited low signal, and the lump was removed by laryngoscope surgery under general anesthesia. Pathological examination showed lipoma. Five years postoperative, her throat discomfort reappeared the laryngoscopy examination showed a pale yellow lump with the size of 2.0 cm x 1.0 cm in the front wall of left side of pyriform. Her MRI fat suppression sequence exhibited low signal again, and the lump was removed by laryngoscope surgery under general anesthesia. Pathological examination showed lipoma and immunohistochemistry proved S100 positive. The patient was discharged a week postoperative and no recurrence was found in the follow up visits in the following year.
Female ; Humans ; Laryngeal Neoplasms ; Lipoma ; Middle Aged

Specialization development of nursing has increasing demand for nursing staff. Competency model is a professional way for the person-post matching, which may replace the job analysis as a new research direction in nursing human resource management. In this paper, the validation and application of nursing competency model were reviewed from the perspectives of competency model, to discuss the thought and method of verifying competency model, so as to lay the foundation for the clinical application of nursing competency model, and promote the rapid development of nursing.

Objective To discuss the nursing cooperation for patients with severe aortic stenosis who are receiving transcatheter aortic valve replacement using balloon-expandable aortic valve stent. Methods Percutaneous interventional transcatheter aortic valve replacement was employed in 9 patients with severe aortic stenosis. Active preoperative preparation, sufficient psychological care, close observation of vital signs and effective surgery cooperation during the operation were carried out. The clinical results were analyzed. Results Successful operation was accomplished in all the nine patients. After the surgery, all patients were in good condition, and no nursing-related complications occurred. Conclusion Correct understanding of the cooperation with the procedure of transcatheter aortic valve replacement using balloon-expandable aortic valve stent, excellent preoperative psychological care and active preoperative preparation, etc. are the most important things to ensure a successful surgery.

Objective To investigate the contamination of clinically used tablet computers,and compare the effec-tiveness of three cleaning and disinfection methods.Methods The front and back surfaces of tablet computers were wiped and detected by handheld adenosine triphosphate (ATP)fluorescence detector,the study was divided into baseline stage and cleaning and disinfection stage.During baseline stage,the tablet computers in use were directly wiped,during cleaning and disinfection stage,the tablet computers were wiped by normal saline-moistened gauze, alcohol-moistened gauze,and wet napkin.Results During baseline stage:20 tablet computers were wiped,the qualified rate was 0,the median of relative light unit (RLU)of ATP detection was 218.00.During cleaning and dis-infection stage,10 tablet computers were wiped in each cleaning and disinfection group,and the qualified rate of normal saline-moistened gauze,alcohol-moistened gauze,and wet napkin groups were 50.00%,0,and 60.00% re-spectively,the median RLU of ATP detection were 28.50,79.00,and 29.00 respectively.Except comparison be-tween saline-moistened gauze and wet napkin groups (P =0.97),multiple comparison of RLU of ATP detection amongthe other groups were significantly different (all P <0.001 ).Conclusion Contamination of medical tablet computers are serious,wet napkin wiping is an ideal method for cleaning and disinfection,but the frequency for cleaning and disinfection needs to be further studied.

Objective To study whether methicillin-resistant Staphylococcus aureus (MRSA)will increase the burden of patients with hospital-acquired pneumonia (HAP).Methods Patients with Staphylococcus aureus HAP in a hospital between January 1 ,2013 and November 31 ,2014 were selected,patients with MRSA HAP were as case group,patients with methicillin-sensitive Staphylococcus aureus (MSSA)HAP were as control group,propen-sity score matching (PSM)analysis were conducted to compare the prognosis of MRSA HAP and MSSA HAP (length of hospital stay, duration from infection to discharge, mortality, total therapeutic cost ). Results APACHE II score in case group was higher than control group before PSM was conducted,length of hos-pital stay and duration from infection to discharge were both longer than control group (40[20,94]d vs 28[21 ,53] d;19[10,46]d vs 17[8,29]d,respectively,both P <0.05).APACHE II score in case group and control group af-ter conducting PSM was not significantly different(P >0.05 ),data were balanced and comparable;there were no significant difference in length of hospital stay between two groups (28[21 ,52]d vs 28[21 ,53]d),duration from in-fection to discharge (15[9,25]d vs17[8,29]d),mortality(10.87% vs 15.22%),and total therapeutic cost (121 013.5[80 747.21 ,176 200]yuan vs 119 911 .2[66 994.08,241 184.7]yuan)(all P >0.05).Conclusion APACHE II score is an important factor affecting prognosis;after balancing this factor,there is no difference in the prognosis of patients with MRSA and MSSA HAP,MRSA HAP can not increase the burden of disease.

Objective To analyze the present medical teaching textbooks and practice skill guidelines,and explore the profound causes of poor hand hygiene idea among doctors.Methods Three sets of unified textbook series used for domestic medical colleges and universities and two sets of manipulation skill guidelines were studies.Statistical method was conducted to analyze whether concepts and methods of hand hygiene,hand-washing and antiseptic han-drubbing were included in these teaching textbooks;as to eight aseptic manipulation skills,coverage of knowledge, steps of hand-washing and antiseptic handrubbing in manipulation skill guidelines were also analyzed.Results The mentioning rate of hand hygiene,hand-washing and antiseptic handrubbing in 8-year and 5-year program teaching textbooks were both 0 ,in nursing teaching textbooks was 1 00 % ;as to 8 aseptic manipulation in 2 sets of skill practice guidelines,mentioning rate of hand washing was 37 .50 % ,and method and steps of antiseptic handrubbing were both 0 .Conclusion School teaching and skill assessment are the basis,it is difficult to form the right idea by only relying on continuing education without basic education.Hand hygiene should be stressed in the written of teaching textbooks,guidelines should be written following the newest progress,so as to form the correct idea of hand hygiene among doctors.

Objective To realize the effect of WHO multimodal hand hygiene improvement strategy (MHHIS)on improving hand hygiene compliance of health care workers(HCWs).Methods From June to December 2012,HCWs in a hospital was intervened by adopting MHHIS,hand hygiene compliance rate before and after intervention was com-pared,and effectiveness of intervention was assessed.Results Hand hygiene compliance of doctors and nurses improved from 14.06%(35/249)and 28.62%(81/283)before intervention to 31.73%(79/249)and 57.60%(163/283)after inter-vention respectively(both P <0.05).Except outpatient and emergency department,hand hygiene compliance of the other departments significantly improved (all P <0.05);hand hygiene compliance of various hand hygiene indicators significantly improved except ‘after contact with patient surrounding’(all P <0.05),the differences were statistically different (P<0.05).Conclusion Using WHO MHHIS can effectively improve hand hygiene compliance of HCWs.

OBJECTIVE: To evaluate the prospective effect of CAUP and applying midline partial glossectomy with UPPP in the treatment of OSAHS. METHOD: One hundred OSAHS patients were distributed into two groups averagely. The patients of the two groups had CAUP and midline partial glossectomy respectively. All patients were followed-up 6 months and 12 months after operation and carried out using PSG every time. RESULT: Therapeutic effect was evaluated by standard of Hangzhou (2002). In general, in 6 months, curative effect was excellent in 41 patients of the group of CAUP, good in 8 patients with effect, bed effect in 1 patients; in 12 months, it was excellent in 28 patients, good in 13 patients, bed in 9 patients. In 6 months, the curative effect the other group were excellent in 44 patients, good in 5 patients, bed in 1 patients; In 12 months, it was excellent in 43 patients , good in 6 patients, bed in 1 patients. In 6 month, the results showed that the effect of the two methods was similar (P > 0.05), but in 12 months the effect of group of CAUP was better than the other obviously (P < 0.01). CONCLUSION This operation could enlarge the narrow area of palatopharyngeal cavity effectively and decrease postoperative complications. It's a safe effective and acceptable surgical procedure.
Adult ; Aged ; Catheter Ablation ; methods ; Female ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Palate ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery ; Tongue ; surgery ; Treatment Outcome ; Uvula ; surgery

Objective To investigate the vaccination status and vaccination willingness of novel coronavirus in HIV/AIDS population in Yunnan.Methods From October 2021 to June 2022,a questionnaire survey was conducted among 2180 HIV/AIDS patients in Kunming,Qujing,Yuxi,Zhaotong,Puer,Baoshan,Lincang,Honghe,Wenshan,Xishuangbanna,Dali,Dehong and Nujiang prefectures.The questionnaire included age,sex,education,nationality,education level,vaccination,adverse reactions within 7 days after the vaccination,safety of COVID-19 vaccine,awareness of effectiveness,vaccination willingness and so on.Results Among the subjects,2109 completed 3 injections,accounting for 96.74%,and 71 were not vaccinated,accounting for 3.26% .Within 7 days of inoculation,local adverse reactions occurred in 116 cases,accounting for 5.50%,and systemic adverse reactions occurred in 56 cases,accounting for 2.66% .Injection site pain,fatigue and muscle pain accounted for the highest proportion of adverse symptoms in different sex,age and the Han nationality,while the proportion of minority adverse reactions was very low,and there was no difference among the different sex and age(P>0.05).The main reasons for the reluctance of HIV/AIDS population to be vaccinated were(recommended by doctors)that HIV/AIDS patients could not be vaccinated(67.61%)and may have serious adverse reactions after the vaccination(19.72%).The factors affecting the vaccination were found by logistic regression analysis,whether they were worried about infecting novel coronavirus(OR = 0.121,95% CI = 0.083～0.640,P<0.001)and how much they knew about COVID-19 vaccine(OR = 28.932,95% CI = 15.469～54.115,P<0.001),safety of vaccination(OR = 13.953,95% CI = 4.819～40.404,P<0.001)and belief in the preventive effect of vaccine(OR = 14.017,95% CI = 4.752～41.348,P<0.001)were significant factors affecting vaccination.Among the 13 prefectures and cities,Dehong(20),Zhaotong(21)and Lincang(14)had the largest number of unvaccinated people.Conclusion After the mass vaccination,the rate of adverse reaction in HIV/AIDS population is low,the symptoms are mild,the correct and scientific advice and guidance from doctors and the full understanding of the harmfulness of the disease,the safety,prevention and effectiveness of the vaccine are the key to complete vaccination and put an end to vaccine hesitancy.

OBJECTIVEThe aim of this study was to explore the association between acquired multi-drug resistant organism (MDRO) and ventilator-associated pneumonia (VAP) in patients hospitalized at the intensive care unit(ICU).

METHODSReal-time monitoring system for hospital infection was used to track VAP patients. The period of study was from January 1, 2013 to December 31, 2013. Both a nested case-control study design and logistic multivariable regression model were performed to explore the association.

RESULTSA total of 142 VAP cases and 342 non-VAP controls were available in this study. Duration of Hospital stay, ICU stay and mechanical days were statistically significant between the case and the control group (P≤0.001). Compared with MDRO negative patient, the MDRO colonization or infection patients showed an 3.05-time increase on the risk of VAP (adjusted OR = 4.05, 95% CI:2.51-5.46). Remarkably,MDRO-positive patients were significantly associated with increased duration of mechanical ventilation and antimicrobial drug use (P < 0.001).

CONCLUSIONMDRO colonized and infection patients would significantly increase the risks of VAP, with prolonged hospitalization and ICU stay. Effective measures should be taken to promote and control patient's safety at the hospital.

Case-Control Studies ; China ; epidemiology ; Cross Infection ; microbiology ; Drug Resistance, Multiple, Bacterial ; Humans ; Intensive Care Units ; Length of Stay ; statistics & numerical data ; Logistic Models ; Multivariate Analysis ; Pneumonia, Ventilator-Associated ; epidemiology ; Respiration, Artificial ; statistics & numerical data ; Time Factors