Objective To investigate the status of safe injection practice in primary medical institutions.Methods 55 primary medical institutions in Hubei Province were randomly selected,questionnaire survey on status of safe injection in primary medical institutions was conducted.Results A total of 55 questionnaires were distributed,50(90.91％) valid questionnaires were obtained.All valid questionnaires were from primary level medical institutions of Hubei Province,16 of which were from community health centers,17 from township health centers,and 17 from village health clinics.None of 50 primary medical institutions repeatedly used syringe and hemostix,all used disposable sterile syringe,only 7(14.00％) medical institutions used retraction type self-destructing syringe.Only 5 (10.00％) medical institutions were equipped with hand hygiene facilities and sharps containers,32 (64.00％) medical institutions didn't provide sharps containers on treatment carts,21 (42.00 ％) injection rooms didn't install hand-drying facilities,18 (36.00 ％)medical institutions didn't provide alcohol-based hand rub on treatment carts and didn't install hand-drying facilities in treatment rooms.Of sharp injures among health care workers (HCWs) reported in 2015,114 HCWs sustained 117 times of injuries,74 cases(63.25 ％) were caused by ampoule.Of medical waste disposal,there existed some problems,such as leakage and repeated use of sharps box,didn't close sharps box timely,as well as without providing sharp containers in locations where sharps might be produced.Conclusion There are a variety of hidden risks of unsafe injection in primary medical institutions,like insufficient facilities and unsafe disposal of medical waste.

Objective To investigate the effects of olfactory bulb(OB) lesion on neural stem cells proliferation and expression of NMDA receptor subunit 2B in subventricular zone(SVZ) of rats.Methods Sixty adult female SD rats were randomly divided into normal group,saline group and OB lesion group.OB lesion was induced by N-methyl-D-aspartic acid (NMDA) injection.Each group was respectively divided into four time points including 3 d,7 d,14 d and 28 d.Immunohistochemistry staining was used to detect the number of Nestin,Ki67 and NR2B-positive cells in the SVZ.Results (1) Nestin positive cells in the SVZ were shown at the different time of three groups.Seven days after OB lesion,IOD value of nestin-positive cells began to increase((29601± 1788)/0.01 mm2,P＜0.05),reached the maximum at 14 d((49800±3701)/0.01 mm2,P＜0.05) and still sustained a high level at 28 day((27600±3209)/0.01 mm2,P＜0.05).(2)Ki67 positive cells in the SVZ were shown at the different time of three groups.The number of Ki67-positive cells was increased significantly at 7 d,14 d and 28 d after OB lesion compared to normal group and saline group (P＜0.05).(3)NR2B immune expression in the SVZ was shown at the different time of three groups.The NR2B-positive cells increased at 3 d after OB lesion(58.80±2.95,P＜0.05),reached the maximum at 14 d(68.40±4.04,P＜0.05).At 28 d of OB lesion,the number of positive cells was reduced,but still sustained a high level(62.20±3.56,P＜0.05).(4)The positive cells of NR2B and Ki67 were highly positive correlation at different time after OB lesion(r=0.968,P＜0.05).Conclusions OB lesion can stimulate neural stem cell proliferation and increases the expression of NR2B.The increased mode of NR2B is in accordance with the schedule of the neural stem cells increase induced by OB lesion.Therefore,it indicates that the NMDA receptor subunit 2B may be involved in neural stem cell proliferation.

Objective To investigate the situation of medical waste management in medical institutions of Hubei Prov-ince,and put forward the improvement strategies.Methods The questionnaires were designed according to the relevant standards,situation of medical waste management in 75 hospitals in Hubei Province was investigated by stratified sampling, 73 available questionnaires were got.Results The construction of medical waste management software and hardware in 73 hospitals were basically met the requirements of the standards,the qualified rates in organization and system management, classification and disposal of medical waste in departments were all >90%;83.56% (61/73)of the hospitals carried out the best environmental practice(BEP)for medical waste;application of more than 40 kinds of disposable medical devices and supplies were reduced;76.71% (56/73)of hospitals’soft infusion bags were collected and recycled by designated company;only 21.54%(14/65)of hospitals send pathological chemical waste liquid to hazardous waste disposal center;disposal ways of orthopedic stainless steel plates were different,56.16% (41/73 )of hospitals treated plates as medical waste,only 35.62%(26/73)of hospitals informed patients how to deal with it,and signed informed consent with patients. Conclusion Medical waste management in medical institutions in Hubei Province has been paid more and more attention, but for special categories of medical waste disposal,such as soft infusion bags(bottles),orthopedic stainless steel plates, and pathological chemical waste liquid,there are some problems,training still needs to be strengthened,the classification and disposal of medical waste needs to be standardized further.

Objective To explore the effect of ATP fluorescence detection on on-site monitoring and supervision of healthcare-associated infection management .Methods ATP bioluminescence analyzer was used to detect the con-tamination status of hands of health care workers(HCWs),the object surfaces,and the cleaning tools in all quarters of 2015,the detection results were timely given feedback,and improvement measures were put forward.Results A total of 1 294 specimens were detected,the overall qualified rate was 62.75%.The qualified rates of hands of HC-Ws,object surfaces,and cleaning tools increased from 54.35%,50.30%,and 60.26% in the first quarter to 76.42%,64.80%,and 79.52% in the fourth quarter respectively,tendency chi-square test showed that difference was statistically significant (all P <0.05).The median of relative light unit (RLU)of hands of HCWs,object sur-faces,and cleaning tools were 20.00,85.00,and 35.00,respectively.Conclusion ATP fluorescence detection for on-site monitoring and supervision for cleaning and disinfection effect can promote the continuous quality improve-ment of hand hygiene and environmental cleanliness.

Objective To evaluate the impact of duration of preoperative smoking cessation on preventing postoperative pulmonary complications. Methods A literature search was conducted at PUBMED, Web of Science, Chinese National Knowledge Infrastructure (CNKI) database, and Wangfang database. Meta-analyses were conducted for randomized trials and observational studies on preoperative smoking cessation and postoperative pulmonary complications published in the period from the establishment of the database to July 2016.Results A total of 14 studies were included,involving 8 060 patients in the quitting group and 2 845 in the control group. Smokers who quit not less than four weeks before surgery had lower risk of complications than those who did not abstain till surgery or quit less than four weeks before surgery(RR 0.77;95%CI 0.68 to 0.88).Smokers who quit not less than eight weeks before surgery had lower risk of complications than those who did not abstain till surgery or quit less than eight weeks before surgery (RR 0.54; 95% CI 0.35 to 0.85). Conclusions Abstaining from smoking for at least four weeks before surgery reduces the risk of postoperative pulmonary complications. Abstaining from smoking for at least eight weeks also reduces the risk of postoperative pulmonary complications and is demonstrated to be more beneficial.

Objective: To explore the practice and effect of transparent supervision in the prevention and control of multidrug-resistant organism (MDRO). Methods: Transparent supervision was introduced to intervene into the MDRO management of monitored departments. Such transparent supervision was aided by IT means, and transparent MDRO control indexes. These indexes included hand hygiene compliance rate, qualification rate of ATP detection of environmental object surface, implementation rate of main MDRO prevention and control measures, MDRO resistance rate, and nosocomial infection incidence. The data before and after the intervention were compared by Chi square test to evaluation the effect. Results: After intervention, the hand hygiene compliance rate increased from 49.83% to 65.61% (χ²=47.389, P<0.001), and the qualification rate of ATP detection of environmental object surface increased from 48.50% to 83.33% (χ²=96.115, P<0.001). Meanwhile, such indexes as prescription of patient isolation, placement of isolation identifiers and that of specialized bedside equipments increased significantly(P<0.001). The MDRO detection rate decreased from 75.08% to 63.31% (χ²=28.123, P<0.001), and the incidence of nosocomial infection decreased from 4.77% to 3.47%(χ²=20.303, P<0.001). Conclusions The practice of transparent supervision could reduce the risk of MDRO transmission at hospitals effectively, proving its importance in ensuring medical quality and patient safety.

The epidemic of the 2019 Novel Coronavirus (2019-nCoV) infection has presented as a grim and complex situation recently. More than 11,000 cases of 2019-nCoV infection has been confirmed in China until February 1 st 2020, which are causing great impact to economy and society, and seriously interfering with ordinary medical practice of otolaryngology and head and neck surgery. This advice guideline discusses the medical protection measures required in the outpatient clinic as well as in operation ward in otolaryngology head and neck department, which aims to protect medical staff from 2019-nCoV infection.