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Objective To analyze the epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP) in adult inpatients, and to provide a theoretical basis for the diagnosis and treatment of CRKP. Methods A total of 753 hospitalized patients with Klebsiella pneumoniae (KPN) infection in our hospital from 2017 to 2021 were selected as the investigation subjects. According to the sensitivity to carbapenem drugs, the patients were divided into carbapenem sensitive Klebsiella pneumoniae (CSKP) group (n=638) and CRKP group (n=115). The age, gender, department distribution, underlying diseases, length of hospital stay, use of antibiotics and other clinical data of all subjects were analyzed by self-made survey scale of our hospital. Univariate analysis and logistic regression analysis were used to analyze the risk factors of CRKP nosocomial infection in adult inpatients. Results Among of 753 KPN patients, 115 cases (15.27%) were detected with CRKP, including 87 males and 28 females. The detection rate of CRKP in different age groups was significantly different (P60 years was significantly higher than that in the age group of 41-60 years, 21-40 years, and 16-20 years (P2 value =0.725, P>0.05). CRKP strains were mainly isolated from oral and maxillofacial surgery (19.13%), infection department (15.65%), geriatric department (15.65%), and ICU (14.78%). The detection rate of CRKP in different pathogenic bacteria samples was different, including sputum (19.40%), urine (15.43%) and blood (12.58%), with statistically significant difference (P<0.05) The respiratory tract sputum specimens were all expectoration. There were significant differences in age, gender, use of carbapenems ≥7 days, invasive procedures, use of antibiotics ≥2 kinds, use of antibiotics ≥14 days, and use of enzyme inhibitors ≥7 days between the CSKP group and the CRKP group (P<0.05). Antimicrobial application time ≥14 days (OR=5.412), invasive operation (OR=6.431), and carbapenem use ≥7 days (OR=5.417) were the risk factors for CRKP nosocomial infection in adult inpatients (P<0.05). Conclusion Nosocomial infection of CRKP occurs mostly in elderly ICU patients. Intervention measures should be given to adult inpatients who have used antibiotics for ≥14 days, invasive procedures, and carbapenem antibiotics for ≥7 days, which can reduce the risk of CRKP infection in inpatients.
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Objective:To investigate the effects of turning head to the opposite insertion side on catheter heterotopia and degree of comfort among PICC catheter patients.Methods:The inpatients with PICC catheter in Hepatological Surgery of Changzhi People′s Hospital from January 2018 to December 2019 were collected as research object, patients from January to December 2018 was assignment to the control group, patients from January to December 2018 was assignment to the experimental group, with 174 cases in each group. They were catheterized with turning head to the opposite insertion side and turning head to the PICC insertion side, respectively. The incidence of catheter heterotopia, complications as well as degree of comfort during the placement of PICC were compared between the two groups.Results:The successful cases of one-time delivery tube and occurred catheter heterotopia were 97.1% (169/174) and 1.2% (2/174) in the experimental group, the index mentioned above were 91.4% (159/174) and 7.5% (13/174) in the control group, the differences between the two groups were statistically significant ( χ2=5.30, 8.43, both P<0.05). The results from survival curve analysis demonstrated that the occurred of catheter-related venous thrombosis and catheter-related bloodstream infections were significantly lower in the experimental group compared to the control group ( χ2=15.23, 8.76, both P<0.05). The score of comfort during the placement of PICC was (15.00 ± 2.19) in the experimental group, which was significantly lower than (16.86 ± 1.88) points in the control group ( t=8.49, P<0.05). Conclusions:Adopting turning head to the opposite insertion side method can improve the success rate of one-time delivery tube, reduce the incidence of catheter heterotopia and reduce the discomfort of patients during PICC catheterization.
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Objective:To explore the impact of nurses' hierarchical management on nurses' professional life quality, nursing quality and nursing risk in emergency department.Methods:A total of 40 nurses who were on duty in the Emergency Department of Tangshan Gongren Hospital from February 2018 to May 2020 were selected for the study. Our hospital performed routine management of emergency department nurses from February 2018 to February 2019. After a 3-month wash-out period, nurses were managed hierarchically from May 2019 to May 2020. According to the practical experience and educational background of nurses, they were divided into 5 levels, namely N0 level assistant nurse ( n=12), N1 level registered nurse ( n=9), N2 level responsible nurse ( n=10), N3 level specialist nurse ( n=5), N4 expert level ( n=4). Before and after the hierarchical management of nurses in the emergency department, the Quality of Nursing Work Life (QNWL) scale was used to evaluate the nurse′s quality of life, and the nursing quality was assessed by the Nursing Service Quality Questionnaire. Analyze the incidence of errors in the nursing process to assess the nursing risk. Results:The scores of work environment, work family balance, social environment, workload score and QNWL total score before the implementation of hierarchical management were 46.33 ± 8.52, 30.01 ± 6.07, 21.45 ± 4.60, 94.52 ± 8.06, 192.31 ± 12.46, respectively. After implementation, the scores were 51.29 ± 4.75,34.62 ± 4.68, 25.89 ± 3.58, 109.43 ± 6.15 and 221.23 ± 10.03, respectively. The scores after implementation were higher than those before ( t value was 3.216-11.435, P<0.05). The scores of human resource allocation, ward management, operating procedures, basic nursing, nurse training, nursing efficiency, nursing record writing, and first-aid goods management were 84.29 ± 9.75, 80.39 ± 12.46, 83.02 ± 5.63, 80.93 ± 9.84, 87.14 ± 6.12, 85.91 ± 8.46, 88.20 ± 6.76 and 83.51 ± 7.18, respectively. After the implementation, the scores were 92.38 ± 4.66, 94.67 ± 3.89, 91.25 ± 6.37, 94.78 ± 3.56, 95.01 ± 3.78, 93.81 ± 4.11, 95.13 ± 3.07, 93.57 ± 4.62, respectively. The scores after implementation were higher than those before ( t value was 4.735-8.371, P<0.05). After the implementation of nurses' hierarchical management, the nursing error rate was 4.44% (8/180), which was significantly lower than 10.00% (18/180) before implementation ( χ2 value was 4.146, P<0.05). Conclusions:The application of hierarchical management of nurses in emergency department can improve nurses' professional life quality, improve nursing quality, and reduce the incidence of nursing errors. It is worthy of popularization and application in emergency department.
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Objective:To sum up nursing experience of a multi-drug resistant patient with upper gastrointestinal hemorrhage who underwent Lateral skull base.Methods:One patient with multi-drug resistant was admitted to our hospital in October, 2019. To observe and prevent the postoperative complications of lateral skull base and to prevent the rupture bleeding of carotid artery. The early detection and treatment the symptoms of upper gastrointestinal bleeding is effective and necessary. Intervention for patient receiving nutrition therapy is promoted.Results:By giving psychological care to improve patient compliance. The patient had no postoperative complications of lateral skull base, and the bleeding symptoms of upper gastrointestinal hemorrhage was controlled in time.Conclusion:The patient was discharged from the hospital with a tracheal tube in a stable condition.
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AL3810, a molecular dual inhibitor of the vascular endothelial growth factor receptor (VEGFR) and fibroblast growth factor receptor (FGFR), has earned the permission of phase II clinical trial for tumor treatment by China FDA. As a reversible ATP-competitive inhibitor, AL3810 targets ATP-binding site on intracellular region of VEGFR and FGFR, whereas, AL3810 lacking interplay with extracellular region of receptors rendered deficient blood-brain tumor barrier (BBTB) recognition, poor brain penetration and unsatisfactory anti-glioma efficacy. Integrin
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Objective To investigate the expression levels of serum vascular endothelial growth factor (VEGF), lactate dehydrogenase (LDH), sugar chain antigen-125 (CA125), and β2-microglobulin (β2-MG) in peripheral blood of patients with diffuse large B-cell lymphoma (DLBCL) and their clinical significances. Methods Thirty cases of DLBCL diagnosed by pathology in Fenyang Hospital of Shanxi Province and Shanxi Dayi Hospital from December 2011 to June 2013, 20 cases of healthy individuals as normal control group were enrolled. The levels of serum VEGF, CA125 and β2-MG in peripheral blood were detected by enzyme-linked immunosorbent assay (ELISA). Serum levels of LDH were detected by the rate method for measuring. Results The expression levels of VEGF, LDH, CA125 and β2-MG in DLBCL patients were higher than those in the healthy control group [(368±194) vs. (156±48) pg/ml, t=5.718, P=0.000;(487±252) vs. (177±32) U/L, t= 6.658, P= 0.000; (58 ±16) vs. (19 ±10) U/ml, t= 9.701, P= 0.000; (3.1 ±1.5) vs. (1.6 ±0.3 ) mg/L, t=5.612, P=0.000]. The expression levels of serum VEGF and LDH in DLBCL patients with stage Ⅲ-Ⅳ were significantly higher than those in patients with stage Ⅰ-Ⅱ [(506±165) vs. (275±154) pg/ml, t= 3.896, P=0.000; (886 ±433) vs. (220 ±86) U/L, t= 5.244, P= 0.000]. The expression levels of VEGF and LDH in DLBCL patients with bone marrow infiltration were higher than those in patients without bone marrow infiltration [(505±201) vs. (299±152) pg/ml, t= 3.148, P= 0.004; (798±463) vs. (331±166) U/L, t= 3.113, P=0.005]. There were no significant differences in the expression levels of VEGF and LDH between patients with A symptoms and B symptoms (all P>0.05). The serum levels of CA125 and β2-MG in the observation group had not relationship with clinical stage, the presence of A or B symptoms and the presence of bone marrow infiltration (all P> 0.05). The high expression of VEGF had correlation with the high expression of LDH in the observation group (r=0.458, P<0.05). Conclusions The expression levels of VEGF, LDH, CA125 andβ2-MG in DLBCL patients before treatment are high, and the high expression levels of VEGF and LDH are closely related to the clinical stage, disease progression and invasion. Combined detection of VEGF and LDH may be a useful predictor of bone marrow involvement in patients with DLBCL.
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Objective To evaluate the clinical value of dual-source CT enterography(DSCTE)for the diagnosis of small intestine diseases.Methods A total of 207 patients with suspected small intestine disease were enrolled in this study.All patients were performed with DSCTE plain scan and enhanced scan.Cross-sectional and multi-planar reconstruction(MPR),maximal density projection (MIP)and other post-processing techniques were used to observe the small intestine lesions,mesenteric blood vessels,abdominal lymph nodes and other solid organ lesions.The imaging diagnosis was compared with final pathological diagnosis.Results Among 207 patients,69 cases of small intestine disease were diagnosed by DSCTE,which were consistent with clinical final diagnosis.There were 138 cases with negative diagnosis of DSCTE,among which 124 cases were consistent with the final diagnosis while 14 cases were missed.The sensitivity,specificity,accuracy,positive predictive value and the negative predictive value of DSCTE in diagnosis of small intestine disease was 83.1%,100%,93.2%,100% and 89.9%,respectively.Conclusion DSCTE can be uesd as a new method of clinical diagnosis of small intestine disease.
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Objective: To investigate the clinical outcome of ovulation induction in patients with poor ovarian response treated with in vitro fertilization. Methods: A total of 120 patients with poor ovarian response in our hospital from Nov 2013 to Oct 2015 were en?rolled and were divided into 3 groups according to the different treatment methods. The clinical outcome were compared. Results:There was no significant difference in fertilization rate, cleavage rate, available embryo rate, good embryo rate and pregnancy rate in 3 groups ( P>0?05) . The time and doses of gonadotropin in minimal ovarian stimulation group were significantly lower than those in antagonist protocol group and luteal?phase ovulation induction group ( P<0?05) . The embryo freezing rate in minimal ovarian stimula?tion group was significantly higher than that in antagonist protocol group ( P<0?05 ) . The number of oocytes in antagonist protocol group was significantly higher than those in minimal ovarian stimulation group and luteal?phase ovulation induction group, and the em?bryo transplantation cancellation rate was lower than those in minimal ovarian stimulation group and luteal?phase ovulation induction group ( P<0?05) . Conclusion: Minimal ovarian stimulation method has good curative effect, and more suitable for the treatment of poor ovarian response.
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<p><b>OBJECTIVE</b>To investigate the value of serum beta-human chorionic gonadotropin (β-HCG) on days 9 (d9) and 11 (d11) after fresh embryo transfer (ET) and frozen-thawed embryo transfer (FET) in predicting the pregnancy outcomes.</p><p><b>METHODS</b>A total of 227 fresh ET and FET cycles performed at the Center of Reproductive Medicine, Qingyuan People's Hospital between Dec, 2012 and Feb, 2014 were analyzed. The data of serum β-HCG levels on d9 and d11 after fresh ET and FET cycles and the pregnancy outcomes were reviewed, and the ROC curve was constructed to determine the optimal cut-off level of serum β-HCG level for predicting pregnancy outcomes.</p><p><b>RESULTS</b>According to pregnancy outcomes, the cycles were divided into non-pregnancy group (group A), biochemical pregnancy group (group B), and clinical pregnancy group (group C). Significant differences were found between the mean serum β-HCG levels measured on d9 and d11 in all the 3 groups (P<0.01). The cycles in group C were further divided into 5 subgroups with single pregnancy (C1), twin pregnancy (C2), early abortion (C3), ectopic pregnancy (C4), or intrauterine pregnancy complicated with ectopic pregnancy group (C5), and all the 5 subgroups showed significant differences in β-HCG measurements between d9 and d11 (P<0.01). On d9 after ET and FET, the optimal cut-off level of serum β-HCG was 49.05 IU/L for predicting for clinical pregnancy, and was 105.15 IU/L for predicting twin pregnancy; the two corresponding cut-off levels of serum β-HCG on d11 was 51.2 IU/L and 241.75 IU/L, respectively.</p><p><b>CONCLUSION</b>The absolute serum β-HCG level on d9 and d11 after fresh ET and FET allows an accurate diagnosis of pregnancy and helps in the prediction of the pregnancy outcomes.</p>
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Female , Humans , Pregnancy , Chorionic Gonadotropin, beta Subunit, Human , Blood , Embryo Transfer , Fertilization in Vitro , Pregnancy Outcome , ROC Curve , Retrospective StudiesABSTRACT
Objective To investigate the value of three-dimensional speckle tracking imaging(3D-STI) in assessment of left ventricular regional systolic function in acute myocardial infarction model of dogs.Methods Left anterior descending (LAD) coronary artery was ligated in 24 adult beagle dogs.Longitudinal strain(LS) of every left ventricular segment before ligation and 180 min after ligation,and the time for acquisition and analysis were obtained using two-dimensional speckle tracking imaging (2D-STI) and 3D-STI.After the experiment,left ventricular myocardium were determined by TTC staining and divided into two groups:infarcted myocardial segments and non-infarcted myocardial segments.Results Experimental model of acute myocardial infarction was established successfully in 20 dogs.After ligation,both LS of 2D-STI and 3D-STI in infarcted myocardial segments were significantly lower (P ＜ 0.01).The time for acquisition and analysis of the images by 3D-STI were significantly shorter than that by 2D-STI (P ＜0.01).The area under the ROC curve of 3D-STI was larger than that of 2D-STI.A cut-off value of-12.56％ for LS of the 3D-STI had 77.9％ sensitivity and 88.2％ specificity in predicting acute myocardial infarction.Conclusions 3D-STI is a convenient,accurate method for evaluating left ventricular regional systolic function.
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Objective To investigate the clinical significance of lymphatic mapping and sentinel lymph nodes (SLNs) biopsy in the diagnosis and treatment of gastric cancer. Methods A retrospective analysis was carried out based on the data of 46 patients who had received D2 gastrectomy from January 2003 to June 2006. The SLNs stained by methylene blue were resected for biopsy. Results The success rate of SLNs biopsy was 83% (38/46). The sensitivity, false-negative rate, accuracy, specificity, negative predictive value and positive predic-tive value of SLNs were 69% (18/26), 31% (8/26), 79% (30/38), 100% (12/12), 60% (12/20) and 100% (12/12). The sensitivity, accuracy and negative predictive value were 100% in patients with tumor in pT1 stage or TNM I stage, or with the diameters of the tumors under 4 era. The tumor site, and the degree of lymph node metastasis affected the success rate of biopsy, and the invasion depth, clinical stage and the degree of lymph node metastasis affected the sensitivity, accuracy and negative predictive value of biopsy. Conclusions The application of sentinel lymph node biopsy using methylene blue in gastrie cancer is feasible. The sensitivity, accuracy and reliability are high in patients at early stage of gastric cancer.
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DNA barcoding is a powerful approach for characterizing species of organisms, especially those with almost identical morphological features, thereby helping to to establish phylogenetic relationships and reveal evolutionary histories. In this study, we chose a 648-bp segment of the mitochondrial gene, cytochrome c oxidase subunit 1 (COI), as a standard barcode region to establish phylogenetic relationships among brine shrimp (Artemia) species from major habitats around the world and further focused on the biodiversity of Artemia species in China, especially in the Tibetan Plateau. Samples from five major salt lakes of the Tibetan Plateau located at altitudes over 4,000 m showed clear differences from other Artemia populations in China. We also observed two consistent amino acid changes, 153A/V and 183L/F, in the COI gene between the high and low altitude species in China. Moreover, indels in the COI sequence were identified in cyst and adult samples unique to the Co Qen population from the Tibetan Plateau, demonstrating the need for additional investigations of the mitochondrial genome among Tibetan Artemia populations.
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Animals , Artemia , Classification , Genetics , Base Sequence , China , DNA, Mitochondrial , Chemistry , Genetics , Electron Transport Complex IV , Genetics , Genetic Variation , Molecular Sequence Data , Phylogeny , Selection, Genetic , Sequence Analysis, DNA , Sequence Homology, Nucleic Acid , TibetABSTRACT
OBJECTIVE To investigate the method of quality control on the whole process in sterilization supply department. METHODS According to issued by Ministry of Health all kinds of criteria and inspections,the whole process in sterilization supply department was analyzed,and then the quality was controlled. RESULTS The whole process of sterilization was standardized,systematized and programmed. CONCLUSIONS The quality control on the whole process is an effective measure to ensure the rate of supply eligibility and support.
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Objective To study the association of sex, body mass index and insulin resistance with serum leptin in patients with type 2 diabetes. Methods one hundred and eight patients were divided into two groups according to BMI: diabetic obese group and diabetic normal BMI group.Their weight and height were measured. Fasting plasma glucose(FPG),fasting true insulin(FTI),postprandial true insulin(PTI),and fasting serum leptin(LEP) were also measured. ISI=1/(FPG?FTI) as insulin sensitivity index were used to analyse the relation between leptin and insulin resistance. Results ⑴The serum leptin,body mass index,FTI and PTI were significantly higher in diabetic obese group than diabetic normal BMI group. ISI was significantly lower in diabetic obese group than diabetic normal BMI group. ⑵Female serum leptin levels were significantly higher than male serum leptin levels in diabetic obese group and diabetic normal BMI group. ⑶Fasting leptin was correlated with sex. Leptin was positively corrected with body mass index,FTI and was negatively corrected with ISI. Serum leptin wasn't correlated with FPG. Conclusin Serum leptin level is associated with sex,BMI and insulin resistance in patients with type 2 diabetes.
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OBJECTIVE:To discuss the influence of drug price reduction and regulation of purchase on the use of anti-infectives in our hospital.METHODS:The use of anti-infectives in5times of drug price reduction was retrospective anal?ysed.RESULTS:The proportion of the sum of money for consumption of anti-infectives in the total sum for drug consumption dropped year by year but the total DDDc of anti-infectives increased year by year.The DDDs and the total DDDc of all kinds of anti-infectives showed different characteristics.CONCLUSION:The macroscopic price reduction for anti-infectives posi?tively affects the rational use of anti-infectives,yet the effect is limited.Microcosmic regulation of purchase offers an indis?pensable effect.
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OBJECTIVE To establish communication and cooperation between disinfection and supply department and clinical departments in order to attain the high level of work for sterile material management and quality supervision.METHODS From Jan 2004 to Sept 2006 we sent our color printed pages about disinfection and sterilization knowledge,whole-way quality supervision,management and safety usage of sterile material to each clinical department as a manner of communication.RESULTS The communication gave a harmony of demand and supply of sterile material between them and guaranteed the whole-way superior service for sterile material supply.CONCLUSIONS The communication with whole-way quality management of sterial material supply between the disinfection and supply department and other clinical departments is very important.