Medical ultrasound technology is widely used for diagnosis and therapy in clinical practice.Ultrasound probes,which are directly contact with patients,pose a potential risk of pathogen transmission.This expert consen-sus was developed by a multidisciplinary team based on international guidelines,standards in China,and the results of a national survey,aiming to reduce the risk of healthcare-associated infection through standardizing reprocessing of medical ultrasound probes,and formulating consensus recommendations with the Delphi method.The consensus clarifies the reprocessing principles for three types of ultrasound probes of different infection risks:external-use ul-trasound probes,interventional percutaneous ultrasound probes,and internal-use ultrasound probes,puts forward systematic suggestions on the reprocessing standards and disinfection levels of ultrasound probe isolation covers and coupling agents,the reprocessing procedures and methods of ultrasound probes,as well as architectural layout and management of reprocessing,so as to provide a scientific prevention and control framework for ensuring ultrasound diagnosis and therapy safety.

Medical ultrasound technology is widely used for diagnosis and therapy in clinical practice.Ultrasound probes,which are directly contact with patients,pose a potential risk of pathogen transmission.This expert consen-sus was developed by a multidisciplinary team based on international guidelines,standards in China,and the results of a national survey,aiming to reduce the risk of healthcare-associated infection through standardizing reprocessing of medical ultrasound probes,and formulating consensus recommendations with the Delphi method.The consensus clarifies the reprocessing principles for three types of ultrasound probes of different infection risks:external-use ul-trasound probes,interventional percutaneous ultrasound probes,and internal-use ultrasound probes,puts forward systematic suggestions on the reprocessing standards and disinfection levels of ultrasound probe isolation covers and coupling agents,the reprocessing procedures and methods of ultrasound probes,as well as architectural layout and management of reprocessing,so as to provide a scientific prevention and control framework for ensuring ultrasound diagnosis and therapy safety.

Sepsis is the most common complication of severe burns and a primary risk factor for endangering the lives of critically severe burn patients. The mortality rate of burn sepsis patients was up to 75%. Neutrophils are one of the innate immune cells and are the earliest and most recruited immune cells at the site of infection, which play a key role in the removal of local infection and the repair of damaged tissue. Many studies have deeply revealed the pathogenesis and progression mechanism of burn sepsis, in which the role of neutrophils has gradually become clear. This paper elaborated on the key mechanisms of neutrophils in the occurrence and evolution of burn sepsis, explored the value of neutrophils in the early warning and prognosis judgement, and the potential therapeutic methods of burn sepsis based on the unique biological behavior of neutrophils in burn sepsis.

Objective: To determine the relationship between dengue virus load and clinical characteristics, so as to provide basis for dengue fever prevention and treatment. Methods : The dengue viral load and typing of 120 patients in Gongshu District of Hangzhou from June to November 2017 were detected by real-time fluorescent quantitative RT-PCR;the clinical indicators of these dengue patients were collected and their correlation with the viral load was analyzed. Results: The DNA detection of dengue virus in 120 patients showed that they were all typeⅡ. The median dengue virus load was 3.91×104 copies/mL. All the patients had fever, the average peak temperature was（38.96 ± 0.69）℃. There were 102（85.00%）cases with asthenia;116（96.67%）cases with white blood cell count（WBC）less than 4× 109/L;119（99.17%）cases with platelet count（PLT）less than 100×109/L;114（95.00%）cases with glutamic oxaloacetate transaminase（GOT）more than 40 U/L;81（67.50%）cases with glutamic pyruvate transaminase（GPT）more than 52 U/L;58（48.33%）cases with creatine kinase（CK）more than 210 U/L. There was no significant correlation of dengue virus load with length of hospitalization, peak temperature,duration of fever, WBC,PLT, GOT, GPT and CK（P>0.05）. There were 75（62.50%）severe patients, and their median viral load was 9.29×104copies/mL, which was higher than 5.33×103copies/mL in non-severe patients（P<0.05）. Conclusion The dengue virus load is not related with length of hospitalization,peak temperature,WBC,PLT,GOT,GPT and CK,but with the severity of the disease.

Objective To report the clinical features,microsurgical techniques and outcomes of 5 patients admitted in our hospital,who had solid hemangioblastoma in medulla oblongata in the last 5 years.Methods 5 consecutive cases of solid hemangioblastoma in medulla oblongata operated from March,2011 to May,2016 were reviewed and fl lowed up.Results All patients suffered headache,dizziness and cerico-occipital pain from the beginning plus one was found because of obstructive hydrocephalus.The mean duration before operation was 6.7 months.The mean maximum diameter of tumor was (33.7±3.4)mm.The suboccipital posterior midline approach was performed and gross total resection was achieved in all 5 cases.After operation,endotracheal tube was removed in all 5 patients,but 3 received tracheotomy,and all patients can take food freely now through rehabilitation exercise.Followed up until September 2016,all patients lived a normal life.Conclusion The operation of solid hemangioblastoma in medulla oblongata is full of huge risk,but microsurgical resection is the only cure means for the tumor.

ObjectiveTo explore the application effects of type 2 diabetes mellitus (T2DM) clinical nursing pathway in clinical nursing education.Methods A total of 24 nursing students practiced in endocrine department of Beijing Electric Power Hospital of Capital Medical University from July 2014 to May 2015 were selected by purpose sampling method as the control group and they received the traditional clinical teaching method. 22 nursing students practiced in endocrine department of our hospital from July 2015 to May 2016 were selected as the observation group and they received clinical nursing teaching plan which was designed based on the clinical nursing pathway. The clinical nursing pathway was established based on T2DM clinical pathway issued by the Ministry of Health of PRC and refined according to the characteristics of nursing work. Test scores of students′ theory and operation were compared between two groups. The questionnaire of patients′ diabetes knowledge was self-designed and was used to investigate the knowledge of patients on diabetes.Results The scores of students′ theory and operation in the observation group were (90.91±3.13) and (92.36±2.59),which were higher than those in the control group [(84.63±3.79),(90.42±3.28)]. The differences were statistically significant (t= -6.103,-2.219;P<0.05). The score of knowledge on diabetes of patients in the observation group (86.23±4.98) was significantly higher than that in the control group (80.13±5.35) (t= -8.568,P<0.01). Conclusions The clinical teaching method based on clinical nursing pathway could guide nursing students to improve clinical practice and comprehensive ability as well as promoting knowledge of patients on diseases.

ObjectiveTo observe the effect of continuous blood purification (CBP) on serum inflammatory mediators in patients with severe acute pancreatitis (SAP) and multiple organ dysfunction syndrome (MODS). MethodsSixty-five SAP patients with MODS who were treated in General Hospital of Chengdu Command Area of Chinese PLA from April 2008 to December 2013 were enrolled and divided into two groups. The 33 patients in the control group received comprehensive internal medicine treatment, and the 32 patients in the treatment group received comprehensive internal medicine treatment and CBP. Changes in APACHE II score, MODS score, and the serum levels of tumor necrosis factor α (TNFα), C-reactive protein (CRP), interleukin 6 (IL-6), IL-18, platelet-activating factor (PAF), and nitric oxide (NO) after treatment were observed. Independent-samples t test was applied for comparison of continuous data between the two groups, and paired t test was applied for before-after comparison within the same group; chi-squared test was applied for comparison of categorical data between the two groups. ResultsIn both groups, APACHE II score, MODS score, and the serum levels of TNFα, CRP, IL-6, IL-18, PAF, and NO decreased significantly after treatment (all P＜0.05), and the treatment group had significantly greater decreases in these values than the control group (all P＜0.001); the survival rates in the treatment group and the control group were 90.6% (29/32) and 78.8% (26/33), respectively, with no significant difference between the two groups (χ2=1.749, P=0.186). ConclusionIn SAP patients with MODS, CBP can effectively clear the serum inflammatory mediators to block systemic inflammatory response and improve organ function, and, therefore, it is an effective method to treat SAP.

Objective To investigate the clinical effects and feasibility of highly concentrated Potassium Chloride via central venous catheterization by micro pump on severe hypokalemia patients in EICU.Methods A totlal of 120 severe hypokalemia patients in our department were randomly divided into experimental group (treated with highly concentrated Potassium Chloride) and control group (normal treatment group) respectively,and treated with Potassium Chloride liquid of different concentration.Potassium levels in blood were checked every hour and the time for reaching standard potassium level (4.0mmol/L) and the total volumes of infusion fluid within 24 hours in the two groups was compared.Results The mean time for reaching standard potassium level and the total volumes of infusion fluid within 24 hours in the experimental group,(12.83 ± 3.57) h and (402.56 ± 54.61) ml respectively,were significantly less than those in the control group (P ＜0.01),(23.18 ±4.98) h and (2875.2 ± 206.26) ml respectively.Conclusion Highly-concentrated potassium chloride injection via central venous catheterization by micro-pump is a safe,effective and feasible treatment on the patients with severe hypokalemia,especially on the patients with volume-overloaded heart and severe hypokalemia,which is worthy of further clinical research.

Objective:To discuss the influence of bifid triple viable enteric-coated capsules on liver function and inflammatory fac-tor in the patients with non-alcoholic steatohepatitis ( NASH) . Methods:Totally 70 cases of patients with NASH were selected and di-vided into the control group and the observation group at random. The patients in the two groups were all given routine hepatoprotective therapy. The patients in the observation group were additionally given 420mg bifid triple viable enteric-coated capsules, three times a day for 4 weeks. Except for bifid triple viable enteric-coated capsules, the patients in the control group were given the same medical treatment as that in the observation group. The changes of liver function index, serum high sensitivity C reaction protein ( hs-CRP) , IL-6 and IL-8 levels in the two groups before and after the medical treatment were observed and the security was compared. Results:After the 4-week medical treatment, ALT, GGT, serum hs-CRP, IL-6 and IL-8 levels in the two groups were obviously declined than those before the treatment (P<0. 05 or P<0. 01), and the declining rate in the observation group was much higher than that in the control group (P<0. 05). Totally 6 and 4 cases of adverse drug reaction (ADR) respectively appeared in the observation group and the control group during the medical treatment with mild symptom, and the difference was without statistical significance (P>0. 05). Conclusion:Bifid triple viable enteric-coated capsules in the treatment of NASH can obviously reduce the serum hs-CRP, IL-6 and IL-8 levels, inhibit the intrahepatic inflammation and immunologic injury, and improve the liver function index with high security.

Objective To investigate risk factors for healthcare-associated infection(HAI)in patients with craniocerebral operation,and provide reference for the prevention and control of HAI.Methods A total of 4 246 cases of craniocerebral surgery in a neurosurgery department from January 2010 to December 2012 were enrolled in the study,the risk fac-tors for HAI were analyzed.Results Of 4 246 cases of craniocerebral surgery,393 patients developed 446 times of post-operative HAI,HAI incidence rate was 9.26%,case infection rate was 10.50%,which were higher than inci-dence (2.02%)and case infection rate (3.02%)of HAI of all hospital during the same period,the difference was statistically significant (χ2 =811 .06,629.30,respectively,P <0.001).The major infection site was central nervous system (56.50%),followed by respiratory system (27.36%).Unconditional univariate logistic regression analysis showed that sex,age,community-acquired infection,primary disease,operative time,length of stay in intensive care unit (ICU)before infection,the number of surgery,invasive procedures and nasogastric tube,the difference was statistically significant (all P <0.05 ).Multivariate logistic regression analysis showed that sex,elderly pa-tients,congenital brain diseases,stay in ICU>7 d,antimicrobial use >7 d,central venous and urinary tract cathe-terization,invasive ventilator were risk factors for HAI in patients with craniocerebral operation.Conclusion The incidence of HAI in patients with craniocerebral operation is high,effective preventive and control measures accord-ing to risk factors should be strengthened to reduce the incidence of HAI.