Objective:To investigate the centralized management mode of cleaning disinfection and for ventilator, monitor, injection pump and infusion pump in our hospital so as to achieve scientific management and further development for hospital.Methods: The qualified rates of ventilator, monitor, injection pump and infusion pump, and satisfied degree of various department for them were analyzed after the centralized management was implemented.Results:After the centralized management was implemented, the cleaning qualified rates of ventilator, monitor, injection pump and infusion pump were, 99.25%, 99.78%, 99.47% and 98.94%, respectively. And the satisfaction scores of various departments for the application of equipment, equipment allocation and equipment recovery were significantly higher than those in 2013 (t=4.18,t=4.62,t=3.86,P<0.01).Conclusion: After the centralized management for routine emergency equipment is carried out by the cleaning disinfection center, the cleaning qualified rates of equipment and satisfaction of various departments has been significantly increased. Therefore, it is worthy to be applied and promoted.

Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Thalamic Diseases ; therapy

Objective To evaluate the difference of efficacy between continuous subcutaneous insulin infusion(CSII)and continuous intravenous insulin infusion(CVII)with human insulin in patients with diabetic ketoaciduria or ketoacidosis(DKA). Methods 120 patients with DKA were randomized into two groups,one was CSII group by a portable insulin pump(60 cases),the other was CVII group(60 cases).Results Both of CSII and CVII were effective in controlling blood glucose levels.CSII therapy provided better glycemic control(P

Acute Disease ; Autonomic Nervous System Diseases ; Child ; Humans ; Male

The feasibility of using cord blood mesenchymal stem/progenitor cells (CB-MSPCs) to regenerate cardiomyocytes and the optimal inducing conditions were investigated. The CB mononuclear cells were cultured in low serum DMEM medium to produce an adherent layer. After expansion, the adherent cells were added into cardiomyocyte inducing medium supplemented with 5-azacytidine. Cardiogenic specific contractile protein troponin T staining was performed to identify the cardiomyocyte-like cells. The results showed that the frequency of CB-MSPCs clones in CB mononuclear cells was 0.5 x 10(-6) and about 1.3 x 10(7)-fold expansion was achieved within 20 sub-cultivation. After cardiogenic induction, 70% CB-MSPCs was differentiated into cardiomyocyte-like cells. It was indicated that low serum culture could expand CB-MSPCs extensively and the expanded CB-MSPCs could be induced to differentiate into cardiomyocyte-like cells in high efficiency.
Azacitidine/pharmacology ; Cell Differentiation ; Cells, Cultured ; Culture Media, Conditioned ; Fetal Blood/*cytology ; Fluorescent Antibody Technique ; Mesenchymal Stem Cells/*cytology ; Myocytes, Cardiac/*cytology ; Troponin T

Objective To compare the cardiac structure and function between diabetic and non-diabetic with different peritoneal transport type.Methods A total of 84 patients with continuous ambulatory peritoneal dialysis (CAPD) in our center for 6 months were enrolled in this study.Forty-six patients of subjects were diabetic,another 38 were non-diabetic.Patients were divided into four groups according to the results of peritoneal equilibration test (PET) and the ratio of creatinine concentration in dialysate solution and plasma (D/P creatinine concentration).Patients with D/P creatinine concentration ＞ 0.65 were with high permeability and otherwise were low permeability.The four groups were diabetic-H (high permeability) group,diabetic-L(low permeability) group,non-diabetic-H (high permeability) group,non-diabetic-L (low permeability) group.The levels of left atrial diameter (LAD),left ventricular diameter(LVD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular ejection fraction(LVEF) were measured before and after 6-month peritoneal dialysis by ultrasonic doppler.Results Before peritoneal dialysis,there were no significant difference in the terms of all parameters among four groups(P ＞0.05).After 6 months of peritoneal dialysis,the albumin levels,IVST,LVPWT and LVEF in diabetic-L group,non-diabetic-L,diabetic-H group and non-diabetic-H group were ((36.57 ± 3.34),(37.21 ± 4.12),(34.19 ± 3.98),(34.51 ± 4.52) g/L respectively;F =9.034),((10.45 ± 1.12),(10.17 ± 1.35),(11.32 ± 1.09),(11.46 ± 1.38) mm respectively;F =7.525),((9.58 ± 1.42),(9.47 ± 1.31),(10.71 ± 1.40),(10.15 ± 1.41) mm respectively; F =4.963) and ((63.98 ± 4.73) ％,(63.92 ± 5.17) ％,(60.12 ± 5.12) ％,(61.43 ± 5.57) ％respectively ;F =6.984),and the differences were statistic significant (P ＜ 0.05).Compared to diabetic-H group and non-diabetic-H group,there were significant difference in the terms of all above indexes between diabetic-L group,non-diabetic-L (P ＜ O.05).Conclusion The peritoneal transport.type of diabetic patients is high permeability,which might be an important factor affecting cardiac complications in patients.

Objective To study early diagnosis and treatment of Wernicke's encephalopathy(WE) in allogeneic peripheral blood stem cell transplantation recipients.Method A 17 years old patient with acute B-lymphocytic leukemia received HLA-matched nonrelative allogeneic peripheral blood stem cell transplantation after conditioning with total-body irradiation/idamycin/cyclophosphamide (TBI/IDA/Cy) regimen.CD25 monoclonal antibody and cyclosporine A+mycophenolate mofetil + methotrexate were administrated for graft versus host disease prophylaxis.Result On the day 8,the platelet was over 20 × 109/L; On the day 10,the neutrophile granulocyte was over 0.5 × 109/L; On the day 28,full engraftment was confirmed by a bone marrow medicolegal identification.The continued nausea and vomiting after HSCT resulted in deficiency of intake and malabsorption.On the day 54,illusion and tremor occurred,and the follow-up brain MRI suggested WE,but the patient died before thiamine replacing therapy.Conclusion WE is also a rare neurologic complication of HSCT,however,it can easily be overlooked.So early radiologic surveillance and treatment for patients with WE is very important to minimize central nervous system complications and unwanted mortality.

Objective To explore the recuperative effect of immunological function and nutritional status on the patients treated by immune enteral nutrition in early stage after severe multiple injury (SMI). Method The patients with SMI,in department of Trauma Surgery,Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technology,between January 2006 to May 2007 were randomly divided into 2 groups: immune enteral nutrition group (IEN group, 20 cases), enteral nutrition group (EN group, 20 cases). The health persons served as the control group(15 cases) .Since 1st postinjury day, all patients were treated with nutritional support. The T-cell subgroup in periphera blood were detected by FCM and the level of PA, RBP, IL-2 and IL-4 in blood serum were detected by ELASA on the 1st, 3rd,5th, 8th postinjury day. Results After the treatment of IEN and EN,the serum levels of PA, RBP and the proportion of T-cell subgroup were significantly increased on the 8th postinjury day compared with on 1st postinjury day (P ＜ 0.01), but there were no differences between IEN group and EN group. The level of IL-4 were significantly decreased and the level of IL-2 were significantly increased in each group on 8th postinjury day, at same time, the level of IL-2 were significantly increased in IEN group compared with EN group (P ＜ 0.05), and the level of IL-4 were significantly decreased in IEN group compared with EN group (P ＜ 0.05). The duration of SIRS was transient and the infected complication was low on the patients treatment by IEN than EN. Conclusions On the patients with severe multiple injury, IEN was most ascendant than EN to improve the immunosuppression and clinical prognosis.

Objective To investigate the synergistic efficacy of different antibiotic combinations against KPC-2 carbapenemase producing Klebsiella pneumoniae strains in vitro and search for effective antibiotic combination.Methods During 2008 - 2009,a total of 24 strains of K.pneumoniae producing KPC-2 carbapenemase were collected from 8 hospitals in the First Affiliated Hospital of Medical School of Zhejiang University,Ningbo LiHuiLi Hospital,Zhejiang People's Hospital,Hangzhou Third Hospital,the Second Hospital of Shaoxing,Hangzhou First Hospital,Fudan University Huashan Hospital,General Hospital of Nanjing Military Region.MLST technique was used for epidemiological analysis.The MIC of antibiotics,such as amikacin,minocycline,imipenem,amoxicillin/clavulanic-acid,ceftazidime,meropenem,gentamicin,cefoxitin,cefepime,rifampicin,polymyxinB,ciprofloxacin were determined by an agar dilution method,the MIC of tigecycline and piperacillin/tazobactain were determined by Etest.The antibacterial activities of cefepime in combination with amoxicillin/clavulanic-acid,amikacin,or ciprofloxacin,amikacin with ciprofloxacin,imipenem with amikacin,ciprofloxacin,polymyxinB,or minocycline,polymyxin B with rifampicin,ceftazidime with amoxicillin/clavulanic-acid were assessed by chequerboard synergy agar dilution tests against all the isolates.Results MLST showed 5 STs among 24 strains of KPC-2 carbapenemase producing K.pneumoniae,and the most prevalent clone was ST11 (15 strains).All isolates were susceptible to polymyxin B and tigecycline,and the resistance rate of minocycline was 4.2％.The synergetic effects were observed in cefepime-amoxicillin/clavulanic acid,imipenem-amikacin,ceftazidime-amoxicillin/clavulanic acid combinations as 19 isolates,13 isolates,and 13 isolates,respectively.Conclusions KPC-2 carbapenemase producing K.pneumoniae is sensitive to polymyxin B,tigecycline and minocycline.The synergetic effect is predominant in cefepime-amoxicillin/clavulanic acid,imipenem-amikacin ceftazidime-amoxicillin/clavulanic acid combinations in vitro,their clinical efficacy are worthy of further observation.

Objective To measure the parameters of ealeaneal quantitative ultrasound(QUS)in nomal Hubei Yichang subjects.which were compared between different age groups after standardization by body mass index(BMI).Methods Calcaneal parameters were measured by UBIS5000 in 2912 normal Hubei Yichang subjects,from 20 to 82 years old women 1450,men 1462).Results The peak values of broadband ultrasound attenuation(BUA)and stiffness(STI)of the calcaneal were both in 45-49 year group for women.The peak value of BUA was in 50-54 year group for men.Standardized by BMI,the peak value of BUA、STI and sound of speed(SOS)were both in 20-24 year groups for women and men.Conclusion BUA、SOS and STI of the calcaneal may change with age.After the influence of body mass is eliminated,the change still exists obviously,and the parameters may gradually reduce with increasing age.