Objective To explore the effect of intravenous infusion team (Ⅳ team) combined with systematic training in safety management of peripherally inserted central catheter (PICC).Methods Totals of 150 PICC patients before training from October 2010 to September 2011 were the control group,and 150 PICC patients after training from October 2011 to September 2012 were the experimental group.Incidence rate of complication and unplanned extubation as well as patients' satisfaction rate were compared between two groups before and after training.Results There were total 10 cases of complication in the experimental group,including 2 cases of catheter infection,3 cases of phlebitis,1 case of catheter separation,2 cases of obstruction and 2 cases of unplanned extubation,while there were total 64 cases of complication in the control group,including 10 cases of catheter infection,15 cases of phlebitis,9 cases of catheter separation,14 cases of obstruction and 16 cases of unplanned extubation,and the difference was statistically significant (x2 =52.30,P ＜0.01).Patients' satisfaction rate was 88.33％ in the control group and 98.3％ in the experimental group,and the difference was statistically significant (x2 =4.82,P ＜ 0.05).Conclusions Ⅳ team plays a leading and radiation role in nursing,which can improve safety management of PICC nursing and the overall service level of hospital care.

[Objective] The aim of our study is to examine nodule prevalence in a population over 40 years old in order to explore the relation between prevalence of thyroid nodules and metabolic parameters.[Methods] A total of 1875 individuals who were over 40 years of age were received the questionnaire and underwent thyroid ultrasonography examinations.Height,weight,waist circumference,blood pressure were measured.Levels of fasting blood glucose,fasting serum insulin,glycated hemoglobin,blood lipids,thyroid stimulating hormone and free T4 were detected.Body mass index (BMI) and homeostasis model assessment-insulin resistance (HOMA-IR) were calculated.[Result] The study included a total of 1875 subjects (513 men and 1362 women).The age of subjects were between 41 and 113 years old,and the mean age was 57.4±7.1 years old.The prevalence of thyroid nodules was 51.2％,and the prevalence of thyroid nodules in women was significantly higher than that in men (53.4％ vs.45.2％,P=0.002).The prevalence of thyroid nodules was significantly higher in subjects with hypertriglyceridemia (59.2％ vs.49.5％,P=0.009) and hypertension (56.5％ vs.47.8％,P＜ 0.001).Result of multivariate binary logistic regression revealed that hypertension (OR=1.405,P=0.002),female sex (OR=1.490,P=0.001),older age (OR=1.028,P＜0.001),and hypertriglyceridemia (OR=1.589,P=0.005) were independent risk factors for thyroid nodules.The prevalence of thyroid nodules increased along with age,systolic blood pressure and serum triglyceride level.[Conclusion] The prevalence of thyroid nodules and metabolism-related diseases were high in population over 40 years old.After adjusted for age and sex,hypertriglyceridemia and hypertension were possible independent risk factors for thyroid nodules especially in women.In general,hypertriglyceridemia and hypertension might play an important role in the pathological process of thyroid nodules.

OBJECTIVES: To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. METHODS: A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. RESULTS: Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). CONCLUSIONS There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.
Bronchopulmonary Dysplasia/epidemiology* ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Pregnancy ; Respiratory Distress Syndrome, Newborn/epidemiology* ; Retrospective Studies ; Treatment Outcome