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Objective To explore the effect of risk assessment method on the incidence of healthcare-associated infection (HAI) in high-risk departments.Methods A hospital was selected as the research object, risk assessment of HAI management at the hospital and department level was carried out, high-risk departments and high-risk links were screened out, targeted intervention was performed. Patients hospitalized in April-June 2017 were as control group and those hospitalized in July-September 2017 were as intervention group, incidence of HAI between two groups was compared.Results Through risk assessment at the hospital level, department of critical care medicine was the department with the highest risk, risk assessment at the department level showed that without wearing isolation clothes when contacting isolated patients during diagnosis and treatment, without using sterile sheeting when catheterization, and low correct rate of hand hygiene were high-risk links in department of critical care medicine. Targeted intervention was performed, isolation clothing allocation rate for contacting isolated patients increased from 0 to 100％, compliance rate to wearing isolation clothing among medical staff increased from 0 to 97.62％, implementation rate of using sterile sheet for deep vein catheterization increased from 72.50％ to 100％; hand hygiene correct rate increased from 85.00％ to 96.59％. Incidence of HAI decreased from 5.90％ to 2.64％, difference was statistically significant (P＜0.05).Conclusion Implementing risk assessment management of HAI in medical institutions can effectively guide the prevention and control of HAI in high-risk departments, and improve the level of HAI management.
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<p><b>OBJECTIVE</b>To investigate the comprehensive treatment of stage-IIIb testicular non-seminomatous germ cell tumor (NSGCT) based on the chemotherapy with cisplatin, etoposide and bleomycin (BEP) and nerve-sparing laparoscopic retroperitoneal lymph node dissection (nsLRPLND).</p><p><b>METHODS</b>We reported a case of stage-IIIb testicular NSGCT, analyzed the clinical data and treatment methods and reviewed the relevant literature.</p><p><b>RESULTS</b>The patient underwent chemotherapy with etoposide (0. 18 g/d for the first 3 days), cisplatin (30 mg/d for the first 5 days), and bleomycin (30 mg/d on day 2, 9 and 16) for 3 cycles, followed by nsLRPLND. Both chemotherapy and surgery were successfully performed. The operation time was 175 min, with intraoperative blood loss of 50 ml, but no severe perioperative complications. No recurrence and distant metastasis were found during the 6-month follow-up after surgery.</p><p><b>CONCLUSION</b>The comprehensive treatment based on BEP chemotherapy and nsRPLND can be used as an option for stage-IIIb testicular NSGCT.</p>
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Adult , Humans , Male , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Combined Modality Therapy , Lymph Node Excision , Methods , Retrospective Studies , Testicular Neoplasms , TherapeuticsABSTRACT
Objective To investigate the correlation between the expression of HIF-1a (hypoxia inducible factor 1,HIF-1a) in perihematomal brain issue and formation of brain edema in patients with hypertensive cerebral hemorrhage.Method Perihematomal brain issue was collected in the course of hematoma elimination in 32 patients with hypertemive intraeerebral hemorrhage.Expressions of HIF-1a and vascular endothelial growth factor (VEGF) were observed by immunohistochemistry.The volume of perihematomal brain edema on computed tomographie scan was determined by computed tomographic scan before surgery.The results of staining and the volume of perihematomal brain edema were analyzed in double blind fashion.Results HIF-1a protein immunohistochemical staining positive cells (2.8?0.8/HP) were identified dispersedly from 4 hours after acute hemorrhagic stroke in perihematomal brain issue,and reached the peak at 24～48 hours (12.5?3.9/HP).High expression of HIF-1a progressed at 48～72 hours (12.2?1.8/HP) after acute hemorrhagic stroke.There was a positive correlation between the expression of HIF-1a and VEGF (r=0.76,t=6.37,P
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Objective To investigate HPV infection and its correlation with the expression of sur- vivin and proliferating cell nuclear antigen (PCNA) in condyloma acuminatum (CA).Methods HPV6/11 and 16/18 DNA were detected by PCR in 41 cases of CA and 23 specimens of normal skin.The expression of survivin and PCNA was measured by immunohistochemical technique in these two groups. Results The infection rates of HPV6/11 and 16/18 were 87.80% (36/41) and 19.51%(8/41),respective- ly,in CA,and 0 in normal skin epidermis.The expression of survivin and PCNA was found in 53.66% (22/41) and 87.80% (36/41) of CA ,and was 8.70%(2/23)and 47.83% (11/23) in normal skin,respec- tively.The expression of survivin was positively correlated with the high expression of PCNA in CA.The expression of survivin and PCNA was higher in HPV6/11 positive lesions than in HPV6/11 negative lesions. Conclusion HPV infection may up-regulate the expressions of survivin and PCNA,inhibit the apoptosis and promote the proliferation of keratinocytes.