Objective To investigate the perioperative use of antimicrobial agents in class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City,and provide a basis for the rational use of antimicrobial agents in such surgeries.Methods Perioperative antimicrobial prophylaxis(PAP)in patients undergoing class Ⅰ incisional ophthalmic surgery reported by secondary first-class and above hospitals in Shanghai City from 2017 to 2022 was collected retrospectively.The prophylactic use rate,types,rationality of selection,and timing of use of antimicrobial agents were analyzed comprehensively.Results From 2017 to 2022,a total of 54 868 cases of class Ⅰ incisional ophthalmic surgeries were reported from secondary first-class and above hospitals in Shanghai City.The PAP rates in tertiary comprehensive hospitals,tertiary specialty hospitals,tertiary traditional Chinese medicine hospitals,and secondary comprehensive hospitals were 4.72％,1.79％,3.22％,and 6.63％,re-spectively.The overall PAP rate showed a yearly decreasing trend,from 6.39％in 2017 to 2.31％in 2021.Among different types of hospitals,the PAP rate in secondary comprehensive hospitals decreased most significantly,from 12.72％in 2017 to 0.53％in 2022.The main types of prophylactic antimicrobial use were first-,second-and third-generation cephalosporins,and quinolones.The rational selection rates of antimicrobial agents were highest in ter-tiary comprehensive hospitals(17.13％)and lowest in tertiary specialty hospitals(1.08％).The PAP rates in sys-temic veins 0.5-1 hour before surgery were highest in tertiary specialty hospitals(88.17％)and lowest in tertiary comprehensive hospitals(71.53％).The withdrawal rates of antimicrobial agents within 24 hours after surgery were highest in tertiary traditional Chinese medicine hospitals(80.87％)and lowest in tertiary specialty hospitals(13.26％).Conclusion The PAP for class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City still presents certain irrational phenomena in terms of antimicrobial types and administration routes.The administration rate 0.5-1 hour before surgery and withdrawal rate of antimicrobial agents within 24 hours after surgery need to be further improved.Enhanced management is necessary to promote more rational use of antimicrobial agents.

Objective To investigate the perioperative use of antimicrobial agents in class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City,and provide a basis for the rational use of antimicrobial agents in such surgeries.Methods Perioperative antimicrobial prophylaxis(PAP)in patients undergoing class Ⅰ incisional ophthalmic surgery reported by secondary first-class and above hospitals in Shanghai City from 2017 to 2022 was collected retrospectively.The prophylactic use rate,types,rationality of selection,and timing of use of antimicrobial agents were analyzed comprehensively.Results From 2017 to 2022,a total of 54 868 cases of class Ⅰ incisional ophthalmic surgeries were reported from secondary first-class and above hospitals in Shanghai City.The PAP rates in tertiary comprehensive hospitals,tertiary specialty hospitals,tertiary traditional Chinese medicine hospitals,and secondary comprehensive hospitals were 4.72％,1.79％,3.22％,and 6.63％,re-spectively.The overall PAP rate showed a yearly decreasing trend,from 6.39％in 2017 to 2.31％in 2021.Among different types of hospitals,the PAP rate in secondary comprehensive hospitals decreased most significantly,from 12.72％in 2017 to 0.53％in 2022.The main types of prophylactic antimicrobial use were first-,second-and third-generation cephalosporins,and quinolones.The rational selection rates of antimicrobial agents were highest in ter-tiary comprehensive hospitals(17.13％)and lowest in tertiary specialty hospitals(1.08％).The PAP rates in sys-temic veins 0.5-1 hour before surgery were highest in tertiary specialty hospitals(88.17％)and lowest in tertiary comprehensive hospitals(71.53％).The withdrawal rates of antimicrobial agents within 24 hours after surgery were highest in tertiary traditional Chinese medicine hospitals(80.87％)and lowest in tertiary specialty hospitals(13.26％).Conclusion The PAP for class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City still presents certain irrational phenomena in terms of antimicrobial types and administration routes.The administration rate 0.5-1 hour before surgery and withdrawal rate of antimicrobial agents within 24 hours after surgery need to be further improved.Enhanced management is necessary to promote more rational use of antimicrobial agents.

ObjectiveTo compare the air disinfection effects of different human-machine coexistence disinfection methods in the high-risk areas of airborne diseases in medical and healthcare institutions, and to provide a reference for the prevention and control of airborne diseases in medical and healthcare institutions. MethodsField trials were conducted in the fever clinic, the infection disease department, and dental clinics of a tertiary hospital in Shanghai, respectively. The existing air disinfection methods (plasma air disinfection machine, circulating air ultraviolet disinfection machine or negative pressure ventilation system), upper-room 222 nm ultraviolet germicidal system, and the combination of the existing air disinfection methods and upper-room 222 nm ultraviolet germicidal system were all used in each location in the experiment group. The control group did not adopt specific air disinfection methods. Air sampling was conducted by the six-level sieve hole microbial sampler or the flat slab exposure method. The daily air sampling time was from 8:00 a.m. to 16:00 p.m., with one sample per hour, and a total of 9 samples were taken. The disinfection effects were compared by calculating the total number of airborne bacteria colonies and the sterilization rate for each disinfection method. ResultsThe total numbers of airborne bacteria colonies in the fever outpatient infusion room, the ward and nurse station of infection disease department of 222 nm group were lower than that in the control group (P=0.005, P<0.001, P<0.001). The total numbers of airborne bacteria colonies in the fever outpatient infusion room and the dental examination room of 222 nm group were lower than that in the control group or plasma air disinfection machine group (P=0.022, P=0.014). The total numbers of airborne bacteria colonies in the nucleic acid sampling room of plasma air disinfection machine group combined with 222 nm group were lower than that in plasma air disinfection machine group (P=0.019). The total numbers of airborne bacteria colonies in the CT examination room of fever clinic of the 222 nm group were lower than that in the circulating air ultraviolet disinfection machine group (P=0.002). The total numbers of airborne bacteria colonies in the CT examination room of 222 nm group combined with circulating air ultraviolet disinfection machine were lower than that of circulating air ultraviolet disinfection machine group and the control group (P=0.008, P<0.001). The air sterilization rate of upper-room 222 nm ultraviolet germicidal system ranged from 48.04% to 73.74%. The air sterilization rate of plasma air/circulating air ultraviolet disinfection machine combined with the upper-room 222 nm ultraviolet germicidal system ranged from 6.86% to 73.77%. ConclusionUpper-room 222 nm ultraviolet germicidal system could effectively reduce airborne colonies in the air and improve air hygiene quality in both clinic and ward environments with high airborne transmission risks.

Animals ; Apoptosis ; Brain/metabolism* ; Male ; Phosphatidylinositol 3-Kinases/metabolism* ; Rats ; Rats, Sprague-Dawley ; Subarachnoid Hemorrhage/drug therapy* ; Thyroxine/pharmacology*

Objective To investigate the incidence and the risk factors for hospital-acquired pneumonia(HAP)in the elderly in Shanghai.Methods This was a muhicenter prospective clinical cohort study.A total of 5299 patients more than 65 years old.admitted into 31 secondary or tertiary hospitals in Shanghai,were enrolled.Measurements of the demographic and potential risk factors reflecting illness severity,nutrition,drug exposure,surgery and ventilation were performed.Pneumonia was classified by the definition of Chinese Medical Association.Risk factors were analyzed by univariate Pearson Chi-squared test and multivariable logistic regression analysis with backward(Likelihood ratio).Resuits Of the enrolled patients,2805 male and 2494 female,255(4.81%)developed hospital-acquired pneumonia.The incidence was 46.75/1000 hospitalizations.Among them 38 died:and the rough mortality was 14.90%.The incidence of HAP was higher in ICU(21.43%),hematology(12.17%),chest surgery(11.41%),and respiratory medicine(7.92%)departments.The mean of acute physiology and chronic health evaluation (APACHE Ⅱ)score was 8.3±3.4(5-31).Multivariable logistic regression analysis with backward (Wald)method found that admission into secondary hospitals.admission into ICU,history of chronic obstructive pulmonary disease≥10 years,immunosuppression,administration of antibiotics,insertion of nasogastric tube,mechanical ventilation,administration of H-2 antagonists or antacid and≤7 d,central nervous system diseases,depressed level of consciousness,supine position,albumin＜35g/L were independent risk factors of HAP in the elderly.Conclusion Hospital-acquired pneumonia in the elderly was the usual type of nosocomial infections.The risk factors identified from this study may prove useful to target future clinical interventions to prevent HAP in the elderly.

OBJECTIVE To evaluate the hand hygiene compliance(HHC) in China.METHODS The field observation for hand hygiene compliance,the hand hygiene material and equipment were performed in parallel in 8 hospitals from Beijing,Shanghai and Guangzhou.RESULTS It was shown that the average hand hygiene compliance before contacting patient was 35.3%,much lower than the compliance after contacting patient(56.5%).The nurse′s HHC(39.3%) was the best among groups before contacting patient,but the physicians took the first place of HHC after contacting patient.The best discipline in HHC was gynecology and obstetrics departments,especially before contacting patient and after contacting other surface,comparatively the worst was the surgeons.Most of hospitals(83.3%) provided the unmedicated detergent for handwashing.The alcohol-based hand rub(ABHR) for hand disinfection was available(56%) in many hospitals,in contrast the HHC with ABHR was quite low(14.2%).CONCLUSIONS These results indicated that the HHC is relatively low and improving adherence to hand hygiene practice is a multidisciplinary and systematic approach in China.It might be essential for promoting the HHC of health care workers,especially the physicians and surgeons,to strengthen the education and enlarge the continuous investment for some hard-ware improvement.

Objective:To investigate whether chitosan-polyelectrolyte complex (CS-PEC) can be used as scaffold for chondrocyte culture and for cartilage regeneration in vivo.Methods:Condylar chondrocytes of fetal mouse were seeded onto the three-dimension gel scaffolds of CS-PEC and cultured.The cultured chondrocytes/CS-PEC complex samples were transplanted subcutaneously into nude mice and the CS-PEC scaffold without chondrocyte was used as the control.The animals were sacrificed 4 and 8 weeks after operation respectively.Cartilage formulation was observed by histological and immunohistochemical methods.Results:In the in vitro culture the majority of cells attached to the CS-PEC surface and expanded rapidly. 4 weeks after transplantation,in the chondrocytes/CS-PEC complex the scaffold maintained mostly the original structure. Hypertrophic chondrocytes appeared in scaffold materials. CollagenⅡwas positive in the new cartilage. 8 weeks after transplantation the scaffold degraded almost completely and new cartilage could be observed. CollagenⅡ and cartilage matrix was positive in the new cartilage and the collagen I was positive in the surrounding fibroblast-like cells. In control transplants,8 week after transplantation some fibre-like tissue formed in the circumference, but there was no new cartilage formation and the collagen II and the cartilage matrix was negative.Conclusions:CS-PEC may be used as scaffold for fibre-cartilage regeneration.

Objective:To study the mandibular movement characteristics of subjects with severe tooth wear (TW).Methods:30 TW patients (24 men, 6 women, mean age 51 years) were served as TW group and 10 subjects with individual normal occlusion were served as control group (7 men, 3 women, mean age 40.5 years). All cases were examined by means of K6-1 Evaluation System manufactured by Myotronics US. The traces of the mandibular opening-closing movement and border movement were recorded.Results:During the movement from mandible posture position(MPP) to intercuspal position(ICP), the TW patients showed unstable characteristic. The velocity showed no significant difference between the two groups during opening and closing, but the congruence and smoothness of traces during the mandibular opening-closing and border movements in the TW patients were a little worse than the controls; and the TW patients had less mandibular movement index(MMI) than the controls(P