Health Policy ; Humans ; Italy ; Occupational Health Services ; organization & administration ; Safety Management

Finland ; Health Policy ; Humans ; Occupational Health Services ; organization & administration ; Safety Management

OBJECTIVE To discuss the characteristics and risk factors of nosocomial infection inpatients with chronic kidney disease.METHODS The data from chronic kidney disease(CKD) patients retrospectively analyzed.RESULTS The nosocomial infection rate of CKD patients was 14.73%,urinary tract was the most comun site,The main-pathogens were Gram-negative bacteria,and then Gram-positive bacteria and fungii.The patients with diabetic nephropathy,lupus nephritis,aging,lower glomerular filtration rate,hypoproteinemia,anemia,and long time duration were easy to get nosocomial infection.CONCLUSIONS Nosocomial infection in CKD patients is related to underlying diseases,age,kidney function,serum albumin level,hemoglobin level,duration time in the hospital.

OBJECTIVE To discuss the clinical traits,pathogenesis and TCM stepwise treatments of fungal urinary tract infection.METHODS According to the risk factors and clinical character of fungal urinary tract infection,we clarified the mechanism of the disease.The principal aspect was spleen-kidney vacuity detriment and the secondary incidental was accumulated damp-heat and static blood in the lower burner,viz weaken healthy qi and excessive pathogenic factor.Hence during the clinical treatment we should regulate faculty condition.In the acute infection period we should give priority to dispel evils supplemented by the recovery of right qi.In the convalescence we should pay more attention to support right supplemented by dispelling.RESULTS The most common pathogen of fungal urinary tract infection was Candida albicans.The TCM stepwise treatments of fungal urinary tract infection together with regulatiy entire faculty condition had the characteristics of high efficacy and few side effects.CONCLUSIONS The TCM stepwise treatments of fungal urinary tract infection has more potentiality which deserves further study.

Objective To evaluate left atrial appendage regional function and movement changes of systolic and diastolic in patients with atrial fibrillation by speckle tracking imaging(STI) and real-time three-dimensional transesophageal echocardiography(RT-3D TEE).Methods Sixty-seven patients underwent RT-3D TEE was divided into 24 controls,22 paroxysmal atrial fibrillation,21 persistent atrial fibrillation.Left atrial appendage was divided into basal,middle and apical segment.Left atrial appendage emptying fraction of the overall (LAA-EF),basal emptying fraction (B-EF),middle emptying fraction (M-EF) and apical emptying fraction (A-EF) was measured by three-dimensional volume measurement.Each segment systolic strain rate (SRS) and diastolic strain rate (SRD) was measured by STI.Results LAA-EF,B-EF,M-EF,A-EF of paroxysmal atrial fibrillation and persistent atrial fibrillation group were lower than those of the control group,and persistent atrial fibrillation group was the lowest in the three groups.Compared with the control group,SRS and SRD of left atrial appendage basal,middle,apical segment was lower in paroxysmal atrial fibrillation group and persistent atrial fibrillation group,and persistent atrial fibrillation group decreased more significantly.Conclusions Paroxysmal atrial fibrillation and persistent atrial fibrillation can lead to left atrial appendage global or local systolic and diastolic function to reduce,and persistent atrial fibrillation decreased more significantly.

Medical educational internationalization has already made teaching medical courses in English more and more important.Nephrology department in Tongji hospital affiliated to Tongji medical college,Huazhong university of science and technology has assumed the responsibility of teaching in English for medical students of five-year program,six-year program,seven-year program,eight-year program,and abroad student for several years.They practiced teaching in English in theory teaching,PBL teaching and clinical teaching according to the characteristics and requisitions of students in different educational systems.They accumulated some experiences,which was conducive to improving the quality of teaching in English.

Objective: To investigate the community promotion feasibility of superficial needling plus club swing for post-stroke motion impairment of the shoulder joint. Methods:A total of 180 cases (duration <1.5 years) with post-stroke motion impairment of the shoulder joint were recruited from three community health centers in Changning District, 60 from each community. They were randomly allocated into an observation group (n=90) and a control group (n=90). Patients in both groups received standard internal and rehabilitation care. Patients in the observation group received additional superficial needling plus club swing. The visual analogue scale (VAS) was conducted before and 60 d after the treatment to evaluate the severity of shoulder pain. The active movement of the shoulder joint and activities of daily living (ADL) were also observed. Results:There were no between-group statistical differences before the treatment (allP>0.05). After a 60-day treatment, the shoulder pain severity, active range of motion of the shoulder joint and ADL in the observation group were significantly improved than those in the control group (allP<0.01). In addition, no adverse events were reported by participants in the observation group. Conclusion:Superficial needling plus club swing plays a positive role in improving post-stroke motion impairment of the shoulder joint. This safe, reliable and economical therapy has good patient compliance and is suitable for community promotion.

To investigate the relationship of blood ATP content with temperature and time of preservation and to establish its mathematical model, adenosine triphosphate (ATP) concentration was applied as the index of the quality of erythrocytes; systematical study on variation of blood preserved in a series of different temperatures from 4 degrees C to 32 degrees C was performed, and a series of experimental data were obtained. The results showed that when the ATP concentration y = f (d, t, s) in preserved blood was given as the continuous function of the time (d), the temperature (t) and the initiate ATP concentration (s), the model was fitted with the theory of linearity regression in symbolic statistics, and the general mathematical physical equation of the variation of preserved blood quality was deduced. According to the equation, the whole blood in CPDA-1 solution could be efficiently stored for 35, 35, 29, 22, 18, 18, 13, 8, 7, 6, 6, 5, 4, 4 and 3 days in 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, 30 and 32 degrees C, respectively. In conclusion, the general tendency of the variation of preserved blood quality according to the temperature and the time was systematically disclosed for the first time, which would be propitious to estimate the blood quality in various temperatures and to instruct clinical blood transfusion.
Adenosine Triphosphate ; blood ; Blood Preservation ; Humans ; Models, Theoretical ; Temperature ; Time Factors

Objective To investigate the risk factors for occult pneumonia(OP) in children with primary nephrotic syndrome(PNS).Methods The clinical data of 115 children with PNS and findings of chest CT from July 2010 to June 2016 at the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.Based on the findings of chest CT,the subjects were divided into 2 groups:OP group and unoccult pneumonia (UOP) group.The comparisons were made between 2 groups,including gender,age,season,course of disease before admitting to hospital,formation of ascites,white blood cells,C-reactive protein,erythrocyte sedimentation rate,total protein (TP),albumin (ALB),total cholesterol,immunoglobulin G (IgG),immunoglobulin E,urine N-acetyl-beta-D-glucosaminidase (NAG) and 24 h urinary protein quantity/body weight.The single factor analysis was performed to analyze above indicators between 2 groups,and the indicators which had statistical significance were analyzed by single factor analysis were analyzed by the multifactor Logistic regression.The receiver operator characteristic (ROC) curve was drawn to evaluate the predicting ability of the indicators for PNS combined with OP.Results Among 1 15 cases,68 (59.1％) PNS patients were complicated with OP.The result of single factor analysis indicated that the risk factors were the formation of ascites,TP,ALB,IgG and NAG (all P ＜0.05).The multifactor Logistic regression showed that ascites,TP and ALB were the risk factors for OP in children with PNS(P =0.003,0.004,0.003).The area under curve (AUC) of ALB was 0.709,and the critical value was 18.55 g/L(P =0.000);the AUC of TP was 0.658,and the critical value was 39.15 g/L(P =0.004).Conclusion The incidence rate of PNS combined with OP was high.With the presence of formation of ascites,TP ＜39.15 g/L and ALB ＜ 18.55 g/L,it may indicate OP for the PNS children which require special consideration clinically and earlier chest CT examination.

Objective To compare the success rate and safety of the short-axis (SAX) approach and long-axis (LAX) approach to ultrasound-guided central venous cannulation.Methods Electronic bibliographic databases including PubMed,Cochrane Library,Science Direct,and Web of Science were searched for randomized controlled trials comparing ultrasound-guided central venous cannulation via the LAX and SAX approaches published during the period from January,2011 to October,2017.We extracted the data from the eligible studies and assessed the first-attempt success rate,overall puncture success rate and complication rate of the two approaches.The relative risk (RR) with the 95％ CI was calculated using a fixed or random effects model.Results Seven randomized controlled trials were included for meta-analysis.The results showed that the first-attempt success rate was significantly higher in the SAX group than in the LAX group (RR=1.27,95％CI:1.11-1.46;P=0.0005,I2=49％),but the overall puncture success rate did not differ significantly between the two approaches (RR=1.04,95％ CI:0.97-1.10;P=0.27,I2=84％).The incidence of accidental arterial puncture with the SAX approach was significantly lower than that with the LAX approach (RR=1.04;95％CI:1.01-1.08;P=0.01,I2=30％).Conclusion Ultrasound-guided central venous cannulation via the SAX approach,as compared with the LAX approach,can increase first-attempt success rate and reduce the incidence of accidental arterial puncture.