OBJECTIVE To explore the application of multiple hospital branches management mode in control of risk of hospital-acqueird infections in a general hospital so as to move forward the infection control threshold.METHODS The risk management closed loop,known as the infection index monitoring-risk assessment-risk re-sponse-effect evaluation-infection index monitoring,was adopted by People's Hospital of Ningxia Hui Autono-mous Region from Jan.to Jun.2024.The risk of infection at different levels of hospital zones,disciplines,clinical departments and risk indices was evaluated by risk matrix method.The correlation between the risk indices of clin-ical department and the risk scores was observed,and the dynamic monitoring was carried out for the change of risk of infection in the clinical departments.RESULTS The risk score was higher in the headquarter and Ningnan Branch than in the Xixia branch;the interquartile range(IQR)value from high to low was as follows:Xixia branch,hospital headquarter,Ningnan branch.The intensive care unit(ICU),nerve center and radiotherapy de-partment were the disciplines at extremely high risk of infection.The ICU,cardiac vascular surgery department and gastroenterology department of the hospital headquarters,the ICU,neurosurgery department and neurology department of Ningnan branch and the ICU and cardiac vascular surgery department of Xixia branch were the de-partments at extremely high risk of infection.The etiological submission rate before drug therapy,implementation of prevention measures for multidrug-resistant organisms(MDROs),cleaning and disinfection and missing report of hospital-acqueird infection cases were the major supervision indices.The absolute values of Spearman related co-efficient between clinical department risk scores and 4 indices-including the isolation rate of MDROs and the inci-dence of hospital-acqueird infection was greater than 0.5.CONCLUSION The risk management closed loop that is applied in the 'one hospital and multiple branches' medical institution may facilitate the dynamic monitoring,as-sessment and intervention the high-risk hospital branches,disciplines,departments and indices,and boost the ca-pability of risk management of infections in medical institutions.

OBJECTIVE To explore the application of multiple hospital branches management mode in control of risk of hospital-acqueird infections in a general hospital so as to move forward the infection control threshold.METHODS The risk management closed loop,known as the infection index monitoring-risk assessment-risk re-sponse-effect evaluation-infection index monitoring,was adopted by People's Hospital of Ningxia Hui Autono-mous Region from Jan.to Jun.2024.The risk of infection at different levels of hospital zones,disciplines,clinical departments and risk indices was evaluated by risk matrix method.The correlation between the risk indices of clin-ical department and the risk scores was observed,and the dynamic monitoring was carried out for the change of risk of infection in the clinical departments.RESULTS The risk score was higher in the headquarter and Ningnan Branch than in the Xixia branch;the interquartile range(IQR)value from high to low was as follows:Xixia branch,hospital headquarter,Ningnan branch.The intensive care unit(ICU),nerve center and radiotherapy de-partment were the disciplines at extremely high risk of infection.The ICU,cardiac vascular surgery department and gastroenterology department of the hospital headquarters,the ICU,neurosurgery department and neurology department of Ningnan branch and the ICU and cardiac vascular surgery department of Xixia branch were the de-partments at extremely high risk of infection.The etiological submission rate before drug therapy,implementation of prevention measures for multidrug-resistant organisms(MDROs),cleaning and disinfection and missing report of hospital-acqueird infection cases were the major supervision indices.The absolute values of Spearman related co-efficient between clinical department risk scores and 4 indices-including the isolation rate of MDROs and the inci-dence of hospital-acqueird infection was greater than 0.5.CONCLUSION The risk management closed loop that is applied in the 'one hospital and multiple branches' medical institution may facilitate the dynamic monitoring,as-sessment and intervention the high-risk hospital branches,disciplines,departments and indices,and boost the ca-pability of risk management of infections in medical institutions.

Adult ; Humans ; Non-alcoholic Fatty Liver Disease/complications* ; Cross-Sectional Studies ; Folic Acid/therapeutic use* ; Risk Factors

Objective:To investigate the progress and prognosis of cervical high-grade squamous epithelial lesion (HSIL) in pregnancy and its effects on pregnancy outcome.Methods:Eighty-five pregnant women who were complicated by cervical HSIL and accepted prenatal care and delivered in Shanghai First Maternity and Infant Hospital from January 2013 to December 2017 were retrospectively recruited as case group. Another 85 pregnant women without cervical lesions were recruited as control. The progress and outcome of cervical HSIL in the case group and the association with delivery mode were analyzed. The pregnancy outcomes were compared between the two groups by two independent sample t-test, Chi-square test or Fisher's exact test. Results:In the case group, the regression rate of cervical HSIL was 29% (25/85) with 10 cases regressing to low-grade squamous epithelial lesion or atypical squamous epithelial cells of undetermined significance and 15 to chronic cervical inflammation; the persistence rate was 64%(54/85); and the progression rate was 7%(6/85). All six progressed patients gave birth to alive babies and one case progressed to invasive cervical cancer and five to HSIL with micro-invasive cervical cancer after delivery. There was no significant difference in the progression rate [7%(4/60) vs 8%(2/25)], regression rate [32%(19/60) vs 24%(6/25)] or persistence rate [62%(37/60) vs 68%(17/25)] between vaginal delivery and cesarean delivery women ( χ2=0.509, P=0.775). The incidence of premature birth of the HSIL group was higher than that of the control group [9%(8/85) vs 1%(1/85), Fisher's exact test, P=0.017], while there were no significant differences in the incidence of other complications or adverse pregnancy outcomes such as intrauterine fetal death, preterm premature rupture of membranes, low-lying placenta, amniotic fluid contamination of Ⅱ-Ⅲ degree, placental abruption, oligohydramnios and fetal distress between the two groups (all P>0.05). Conclusions:The progression rate of HSIL during pregnancy is low. Thus, a close follow-up could be conducted if invasive carcinoma is ruled out and the postpartum treatment should base on pathological results. HSIL during pregnancy could increase the risk of preterm labor, but is not an indication of cesarean section.

OBJECTIVETo observe the effect of electroacupuncture(EA) at Zhongwan(CV 12) on the energy metabolism along the conception vessel(CV) in volunteers with yang-deficiency constitution,and to explore the relationship of electroacupuncture regulation and body constitution.

METHODSEighteen volunteers with mild constitution and 18 volunteers with yang-deficiency constitution were collected out of 200 students of Fujian University of TCM by body constitution questionnaire. Skin microcirculatory blood perfusion units (MBPU) at Danzhong (CV 17), Xiawan(CV 10) and Qihai(CV 6) of CV were measured by a laser Doppler flowmetry in the normal condition and after EA stimulation at Zhongwan(CV 12) for 20 min.

RESULTS(1)Before treatment, (1)MBPU values at Danzhong(CV 17), Xiawan(CV 10) and Qihai(CV 6) in the yang-deficiency constitution group were lower than those in the mild constitution group,but there was no statistical significance (both P>0. 05) except Danzhong(CV 17) (P<0. 01). (Z)As for the three acupoints in the mild constitution group, MBPU level of Danzhong(CV 17) was higher than that of Xiawan(CV 10) without statistical significance(P->0. 05),and MBPU values of Danzhong(CV 17) and Xiawan(CV 10) were higher than that of Qihai(CV 6) (both P<0. 01). (3About the three acupoints in the yang-deficiency constitution group, MBPU result of Danzhong(CV 17) was lower than the value of Xiawan(CV 10), but higher compared with Qihai(CV 6)(P<0. 05, P<0. 01). MBPU of Xiawan(CV 10) was higher than Qihai (CV 6) as well(P<0. 01). (2) MBPU values of Danzhong(CV 17), Xiawan(CV 10) and Qihai(CV 6) were increased apparently compared with those before treatment after EA stimulation at Zhongwan(CV 12) for 20 min in the two groups(all P<0. 01). (3) The rise rates of MBPU level about Danzhong(CV 17) and Qihai(CV 6) in the yang-deficiency constitution group were higher than those in the mild constitution group without statistical significance after EA at Zhongwan(CV 12) for 20 min(both P>0. 05).

CONCLUSIONThe energy metabolism in CV of volunteers with yang-deficiency constitution is declined, especially Danzhong(CV 17). EA can rise energy metabolism in CV of mild or yang-deficiency constitution volunteers through regulating MBPU along meridian.

Acupuncture Points ; Adolescent ; Adult ; Electroacupuncture ; Energy Metabolism ; Female ; Humans ; Male ; Meridians ; Microcirculation ; Skin ; blood supply ; metabolism ; Volunteers ; Yang Deficiency ; metabolism ; physiopathology ; therapy ; Young Adult