Objective To investigate the incidence of healthcare-associated infection (HAI)in patients in a respiratory in-tensive care unit (RICU)of a teaching hospital,and provide reference for HAI prevention and control.Methods All pa-tients admitted to this RICU from January to December 2014 were surveyed with prospective targeted monitoring method, surveyed data were analyzed statistically.Results A total of 561 patients were surveyed,43 patients developed 44 times HAI,HAI rate and HAI case rate were 7.66% and 7.84% respectively,incidence of HAI and adjusted incidence of HAI per 1 000 patient-days were 6.26‰ and 1.79‰ respectively.The main infection site was urinary tract (45.46%,n=20). Incidence of ventilator-associated pneumonia (VAP ),catheter-related bloodstream infection (CRBSI),and catheter-associat-ed urinary tract infection (CAUTI)per 1 000 catheter-days were 2.73‰(n=13),1.57‰(n=2),and 3.78‰(n=18)re-spectively.Incidence of HAI per 1 000 patient-days between the first and second half year of 2014 was significantly differ-ent(4.59‰ vs 7.89‰;u=-1.75,P =0.04).A total of 47 pathogenic strains were isolated,the main pathogens were gram-negative bacteria(n=26,55.32%).Conclusion The major HAI in RICU is device-associated infection,it is necessary to strengthen the management of invasive procedures;targeted monitoring can find the weak links of infection control prac-tice and helpful for taking effective prevention and control measures to reduce the incidence of HAI in ICU.

Objective To evaluate the effects of small interfering RNA (siRNA) against peptidylarginine deiminase 4 (PADI4) gene on apoptosis of fibroblast-like synoviocytes (FLS) from synovium of rheumatoid arthritis (RA).Methods The siRNA targeting PADI4 was constructed and transfected into FLS cells in RA via LipofectamineTM 2000.The expression level of PDAI4 mRNA was detected by using real-time quantitative polymerase chain reaction (real-time PCR).The protein expression of PADI4,CyclinB1 and P21 was detected by Western blotting.The apoptosis of FLS cells in RA was examined by flow cytometry.The levels of IL-1β were detected by ELISA.T-test was used for statistical analysis.Results siRNA-PADI4 efficiently down-regulated the PADI4 expression compared with control group,1.00±0.20 vs 0.38±0.20 (t=9.607,P＜0.01),0.39±0.23(t=8.394,P＜0.01).FCM analysis showed that the percentage of apoptosis cells in PADI4 siRNA group in FLS was (5.4±0.6)％ (t=-19.223,P＜0.01) and (6.1±0.6)％ respectively (t=-24.229,P＜0.01),which was significantly higher than that in the control group in FLS (1.6±0.3)％.The expression of CyclinB1 protein was decreased,and P21 increased.The concentrations of IL-1β in culture medium of the transfected group were (26.8±0.7) ng/ml (t=-10.747,P＜0.01) and (27.7±0.7) ng/ml (t=-10.967,P＜0.01),higher than the control group [(23.9±0.7) ng/ml].Conclusion After being transfected with PADI4 siRNA,the apoptosis of FLS cells in RA is increased.Our results have demonstrated the potential role of CyclinB1 and P21 in PADI4 signaling.

Objective To explore strategies and measures to improve hand hygiene (HH)compliance and correctness of health care workers (HCWs)in a large hospital.Methods The WHO multimodal hand hygiene improvement strategy was adopted by healthcare-associated infection(HAI)management department of a hospital,measures consisted of five key com-ponents,including:system change,education and training,evaluation and feedback,reminders in the workplace,and insti-tutional safety climate.HH compliance and correctness of HCWs were observed by infection control practitioners,HH compliance and correctness in January-June of 2012 (pre-intervention)and January-June of 2014 (post-intervention)were compared,effectiveness of intervention strategies were evaluated.Results HH compliance rate and correctness rate of post-intervention were both higher than pre-intervention (75.92% [8 369/11 023]vs 53.67% [5 127/9 553],P <0.001;94.11%[7 782/8 269]vs 83.88%[3 642/4 342],P <0.001).Of different occupations,HH compliance rates of doctors and nurses were significantly different before and after intervention (both P <0.001),while workers and staff of other oc-cupations before and after intervention were not significantly different(both P >0.05).Except ‘after body fluid exposure’, HH compliance rates of the other four indications for HH before and after intervention were significantly different(all P <0.001).Conclusion HH compliance and correctness of HCWs can be improved after adopting WHO multimodal hand hy-giene improvement strategy.

OBJECTIVETo investigate the incidence, risk factors and preventative methods associated with chyle leak following complete mesocolic excision(CME) for colon cancer.

METHODSClinical data of 592 patients with colon cancer undergoing CME in the department of Colorectal Surgery in the Fujian Medical University Union Hospital from September 2000 to September 2011 were analyzed retrospectively.

RESULTSChyle leak occurred in 46 patients(7.7%). The incidence of postoperative chyle leak following right CME hemicolectomy was 13.3%(30/226), significantly higher than that after left CME hemicolectomy (4.4%). On univariate analysis, chyle leak following CME was associated with tumor size(P<0.05), tumor location(P<0.01), and lymph nodes harvested(P<0.01). Multivariate logistic regression revealed that tumor location and lymph nodes harvested were independent risk factors associated with chyle leak following CME(P<0.05).

CONCLUSIONSTumor location and lymph nodes harvested are independent risk factors for chyle leak following complete mesocolic excision for colon cancer. When the drainage output suddenly increases after oral intake resumption, the chyle test of ascitic fluid should be performed for early diagnosis and prompt management.

Aged ; Chylous Ascites ; etiology ; Colonic Neoplasms ; surgery ; Female ; Humans ; Male ; Mesocolon ; surgery ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Risk Factors

Adolescent ; Child ; Child, Preschool ; Cytomegalovirus Infections ; complications ; Female ; Humans ; Kidney Diseases ; etiology ; Kidney Glomerulus ; pathology ; Male

OBJECTIVETo investigate the clinical value of 64-slice computed tomographic angiography (CTA)-based virtual colonoscopy in the diagnosis of colonic tumors.

METHODSPhilips/Brilliance 64 CT volumetric scanning was performed in 8 patients with colonic cancer and 2 with colonic polypi identified by postoperative pathological examination. Mimics software was used for surface rendering of the intestine with the Marching Cubes algorithm for 3-dimensional (3D) virtual endoscope (VE) reconstruction and CTA-based 3D reconstruction of the large intestine and the surrounding structures. The location, volume and appearance of the lesions displayed by the virtual techniques were compared with the pathological results.

RESULTSThe 3D reconstruction was successfully completed in all the 10 cases, and the imaging diagnoses showed a total match with the pathological diagnoses. No significant differences were found between virtual endoscopy and CT virtual endoscopy. Virtual colonoscopy combined with digital model reconstruction provided valuable information for accurate identification of the position of the lesions and the complex adjacent anatomical structures.

CONCLUSIONVirtual colonoscopy based on 64-slice CTA, when combined with 3D reconstruction technique, allows accurate display of the colonic lesions and potential metastasis, which can be crucial for clinical staging and surgical planning of colonic cancer.

Adult ; Angiography ; methods ; Colorectal Neoplasms ; diagnostic imaging ; therapy ; Female ; Humans ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Tomography, Spiral Computed

OBJECTIVETo investigate the elastic limit and relevant enclasp force of the non-precious metal casting clasp.

METHODSCasting clasp samples of five cobalt-chromium alloys and one 18 - 8 nickel-chromium alloy were made from prefabricated clasp wax by invesing, casting, sandblasting, and ultrasonic cleaning. The process of casting clasp samples deflected by loading and returned by unloading was tested and electric signals were collected by an omnipotent material machine. The analog electric signal was converted to digital signal by an analog to digital converter and stored in a computer. The elastic limit and the relevant enclasp force were analyzed using a relative software.

RESULTSThe elastic limit and the relevant enclasp force of the casting clasp made from the 18 - 8 nickel-chromium alloy were smallest and those of the clasps made from the cobalt-chromium alloys in various brands were different. The range of the elastic limit of the cobalt-chromium alloy casting clasp with the length of 5.0 mm in undercut was 0.28 mm-0.33 mm and the relevant enclasp force was 14.42 g-19.28 g.

CONCLUSIONSIn clinic, we should select the suitable undercut deepness wherein the cobalt-chromium alloy casting clasps, according to different brands of the casting alloy, undercut length, undercut slope, and the clasp thickness.

Chromium Alloys ; Cobalt ; Dental Alloys ; Dental Clasps ; Dental Stress Analysis ; Denture, Partial, Removable ; Elasticity ; Humans ; Nickel ; chemistry ; Stress, Mechanical

Objective To evaluate the safety of mefformin in the treatment of elderly type 2 diabetes mellitus(T2DM). Methods Two hundred and forty-three cases of elderly T2DM hospitalized from Jan.1996 to Dec. 2006 were reviewed; the changes of fasting blood glucose(FBG), postprandial blood glucose (PBG), glycosylated hemoglobin (HbA1c), liver and renal function and blood lactic acid were evaluate before and after treatment. Results The mean time of treatment with mefformin was (6.6±3.9) years (3 months-21 years)in these 243 cases. The levels of FBG, PBG and HbAlc significantly reduced after treatment with mefformin only in 43 cases (17.7%), mefformin combined with other oral hypoglycemic drugs in 124 cases (51.0%) and mefformin combined with insulin in 76 cases (31.3%). There was only 18.1% of the cases with normal range ( > 80 ml/min) of creatinine clearance rate (Ccr), and 25.8% of the cases with Ccr≤50 ml/min. The liver and renal function as well as the blood lactic acid had no significant change after treatment no matter in total cases or in different groups separated by Ccr.Conclusions Mefformin is safety in the treatment of elderly T2DM patients. Ageing is not the contraindication of mefformin. To the patients with high risk, we should monitoring the level of blood lactic acid.

Aged ; External Fixators ; Female ; Follow-Up Studies ; Fractures, Bone ; complications ; physiopathology ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Osteoporosis ; complications ; Tomography, X-Ray Computed ; Treatment Outcome

Objective To establish a quantitative RT-PCR method with self-quenched fluorogenic probe for detection of bcr/abl mRNA in patients with chronic myeloid leukemia for providing a useful tool for diagnosis of CML,evaluation of therapeutic effect and monitoring of minimal residual disease(MRD). Methods bcr/abl gene from cultured K562 cells was amplified by conventional RT-PCR.The standard quantitative plasmid was constructed by A-T clone method.The self-quenched fluorogenic quantitative RT- PCR method(FQ-RT-PCR)for determination of bcr/abl mRNA was established successfully using the ABI PRISM 7000 PCR Detector.The linear range,sensitivity,stability,and repetitiveness of the method were determined.The marrow samples from 25 CML patients and 3 ALL patients were assessed.Results The sensitivity of the FQ-RT-PCR was 10 copies/?l recombined plasmid,and bcr/abl mRNA can be detected from 1 K562 cell in 10~5 normal cells.The linear range was 10~2-10~9 copies/?l recombined plasmid.The coefficient variation(CV)value was 2.1% in intra-assay and 6.1% in inter-assay.The median ber/abl mRNA expression level was 4.50?10~4 copies/?g RNA [(0.45-89.00)?10~4],5.45?10~4 copies/?g RNA [(2.95-19.30)?10~4 ],13.00?10~4 copies/?g RNA [(4.10-89.00)?10~4] and 2.35?10~4 copies/?g RNA [(0.45-5.12)?10~4] in 25 CML patients,11 patients in the incipient chronic phase,6 patients in blastic crisis,8 patients in chronic period after treatment,respectively.The bcr/abl mRNA level in blastic crisis was significantly higher than that in chronic phase(q= 3.41,P