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Objective To compare the field-matching techniques and dosimetric characteristics in the target area of testicular seminoma including the abdominal and pelvic cavities between direct aperture optimization intensity modulated radiation therapy (DAO-IMRT) and 3D conformal radiation therapy (3D-CRT),and to analyse the advantages and disadvantages of DAO-IMRT.Methods DAO-IMRT and 3D-CRT plans were designed with Pinnacle treatment planning system for 7 testicular seminoma patients,and the characteristics of both the irradiation methods were analyzed and evaluated by means of the parameters like dose homogeneity indexes,dose volume histograms and etc.Results DAO-IMRT had the hot and cold volumes in the target areas both significantly smaller than those by 3D-CRT,while the conformity index and homogeneity index superior to those by 3D-CRT.The mean doses (Dmean) by DAO-IMRT of the organs at risk (OAR) except the left femur head were all lower than those by 3D-CRT,aud the V15 values of liver,double kidney,small intestine and rectum by DAO-IMRT were statistically lower than those by 3D-CRT (P＜0.01).3D-CRT had the V5 values of OAR all lower than those by DAO-IMRT,in which the differences of double kidney,small intestine,bladder,left femur head and normal tissues were significant statistically (P＜0.05).The monitor units by DAO-IMRT roughly doubled when compared with those by 3D-CRT,and the difference was also significant (P＜0.01).Conclusion DAO-IMRT with easy operation and high reliability can avoid the connection of fields in the target area of testicular seminoma,and is superior to 3D-CRT in dosimetry.
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OBJECTIVE To investigate the status of the clinic intern′s injury,analyze its risk factor and discuss the protection measures.METHODS A survey among 122 clinic interns was performed by questionnaires.RESULTS 31.15% of clinic intern had education about Professional protection,and 94.26% of clinic interns expected to have this kinds of educaion.Clinic interns were lack of knowledge about professional injury and protection obviously.CONCLUSIONS The hospitals and clinic teacher should strenghen the safety education for their clinic interns and provide necessities for their protection.
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OBJECTIVE To study resistance and the change of Pseudomonas aeruginosa of respiratory system infection,and instruct the antibacterial medicine to use rationally.METHODS The respiratory system infection patients from Jun 2004 to Dec 2005 were investigated.To the results of MICs with 229 P.aeruginasa strains were analyzed.RESULTS From inspected 5411 phlegm samples derived from Jun 2004 to Dec 2005,bacteria from 2291 samples(42.34%) were examined out,from them 229 strains(10.00%) were P.aeruginosa. The sensitive rate to tobramycin,imipenem/cilastatin sodium,piperacillin sodium,amikacin sulfate,ceftazidime,cefoperazone/sulbactam(Sulperazon),et al was greater than 60%.CONCLUSIONS We should consider the mechanism of P.aeruginosa resistance in treatment of respiratory system infection patients,and guide the management of antibacterial using.
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OBJECTIVE To investigate the distribution and resistance of Pseudomonas aeruginosa isolated during Jan-Dec 2006.METHODS The clinically isolated P.aeruginosa strains were collected cultured and identified by paper diffusing method or trace dilution method(MIC),the results were evaluated according to the relevant documents of NCCLS of USA.RESULTS The in vitro susceptibility test of 244 P.aeruginosa isolates to 16 kinds of antibacterials indicated the resistance rate to SMZ was the highest(98.8%);then to minocycline,tetracycline and ticarcillin/clavulanicacid(70.1%,58.6% and 54.5% respectively).CONCLUSIONS To strengthen the continuous survezillance of drug resistance of P.aeruginosa,to sum up the resistance rules of main pathogens of departments in hospital and to reduce of production of resistant bacterica have the important significance.
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OBJECTIVE To undersand neurosurgical hospital infection characteristics and bacterial resistance,and to provide reference information for the rational use of antibacterial drugs in clinics.METHODS Using the combined methods of initiative monitoring and recalling system to carry on the clinical informations' statistics,the analysis and the judgment for the 880 inpatients in the neurosurgery department in 2005.RESULTS The rate of neurosurgical hospital infection was 16.36%,significantly higher than the hospital average rate(9.18%) at the same period.Neurosurgical hospital infection pathogens were mainly Gram-negative bacteria.Infection sites occurred mainly in urinary tract(44.44%),followed by lower respiratory tract(35.42%).Sixty strains were Escherichia coli(20.2%),34 strains(11.44%) for Enterococcus faecium(D group),25 strains(8.42%) for Acinetobacter baumannii,25 strains(8.42%) for Pseudomonas aeruginosa,and 18 strains(6.06%) for Klebsiella pneumoniae.CONCLUSIONS Systematic monitoring of neurosurgical hospital infection characteristics and dynamics of bacterial resistance has important clinical reference significance to the rational use of antibacterial drugs.
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OBJECTIVE To explore associated factors of nosocomial infection and provide ways for control nosocomial infection.METHODS The associated factors of nosocomial infection were analyzed by using retrospective analysis in 29 842 cases from Jan 2004 to Dec 2005.RESULTS Among 29 842 cases,1917 cases were infected,the incidence was 6.4%.CONCLUSIONS The associated factors of nosocomial infection are age,the underlying diseases,the decrease in immunological function and the invasive manipulation.
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OBJECTIVE To evaluate the direct economic losses caused by nosocomial infection(NI) in patients with cerebral infarction.METHODS All patients(79 with NI as case group,300 without NI as control group) in pairs were investigated through case-control study retrospectively.RESULTS The average of expenses on medical service in NI group was higher when compared to that of control,the increased medical charge was 3 873.56 yuan and the increased hospitalized charge was 6 254.92 yuan.The average bed-staytime of NI group exceeded that of control by 11 days,there was a significant difference between two groups(P
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OBJECTIVE To set up the infectious disease monitoring platform upon the hospital information system(HIS).In order to study the infectious disease′s early discovery,early reporting,early therapy and early control,to improve the hospital′s capability of prevention and cure of the infectious disease,generally improving the medical treatment quality.METHODS The computer technic was used to auto-collect,save,process the patient′s information.RESULTS To realize the information be shared;play a role in real time effective monitor;to provide the basic information of medical treatment,scientific research,education and management.CONCLUSIONS Realizing the scientific,standardized,systematized management of hospital infectious disease is becoming an important part in the whole HIS as the hospital medical treatment control system.
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OBJECTIVE To understand the characteristic of hospital infection among tumor patients and give information to reduce the tumor patients with hospital infection.METHODS Using the methods of initiative monitoring and the system review to carry on the statistics,analysis,and evaluation for the total of 2679 tumor patients occurred in Department of Oncology in Shaoxing People′s Hospital in 2005.RESULTS Among them there were 120 cases occurred hospital infection.The rate of hospital infection was 4.47%.The patients who infected one time were 179 cases,two times were 31 cases,and over three times were 10 cases.The main infected sites were respiratory tract including upper respiratory tract(38 cases) and lower respiratory tract(36 cases),followed by alimentary tract(10 cases),blood(9 cases),surgical incision infection(8 cases),urinary tract(6 cases) and the other locations(13 cases).CONCLUSIONS The main prevention and control measures of hospital infection among tumor patients are to improve the body immunity and control endogenous infections.
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OBJECTIVE To set up a multiple functional information system for prevention, health care and hospital infection management in order to substitute the primitive older methods.METHODS On the platform of hospital information system, to construct above mentioned system, adopting C/S framework, the backstage supporter adopted the large-scale database of SQL SERVER 2000 enterprises edition, the front application program used Power Builder7 programming. The application software where collected all data about happened public health event, infectious disease epidemic situation and hospital information management was integrated into the each work station of the information system of hospital management, in order to form the report related to any department of the hospital, and control network. RESULTS System could come down with the public health event to which every hospital department could find the infectious disease case, hospital infection case, etc. to check, put in order, report, count, analyze, have a look around, inquire about, feedback, and form the monitoring chart with excellent pictures and texts. CONCLUSIONS This software is a medical quality control system of a hospital, can to meet suddenly public health event, infectious disease epidemic situation and hospital infection control, and raise working efficiency in real time to control hospital infection.
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OBJECTIVE To analyze the current situation of the hospital.and the community-acquired infections due to Staphylococcus aureus(SAU) and provide the reference for clinical reasonable use of drugs.METHODS The clinically isolated S.aureus strains during 2004-2006 were collected,cultured and identified.Their susceptibilily to 16 kinds of antibacterials was detected by K-B or MIC and WHONET5 software was used to analyze the result.RESULTS From 440 S.aureus strains,the meticillin-resisstant S.aureus(MRSA) was 260 accounting for 59.1%;the meticillin-sensitive S.aureus(MSSA) was 180 accounting for 40.9%.The resistant rate of SAU to penicillin G was the highest(85.5%),that to vancomscin was 0.CONCLUSIONS MSSA still keeps fairly good sensibility to most antibacterial medicine,but MRSA shows the multidrug resistance,except to vancomycin.For this studying the resistance mechcnism of Staphylococcus and continuously detecting the emergence of vancomycin-intermediat and vancomycin-resistante S.aureus have a significant clinicil importance.
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OBJECTIVE To understand the antibiotic resistance of Pseudemonas aeruginosa isolated from ICU and give advices to clinicians.METHODS The antibiotic susceptibility of P.aeruginosa isolated from ICU to 12 kinds of antibiotics were tested by disc diffusion method.RESULTS The antibiotic susceptibility of 472 P.aeruginosa strains to imipenem,piperacillin/sulbactam,piperacillin,amikacin,ceftazidime,tobramycin,cefepime,ciprofloxacin,ceftriaxone,gentimicin,aztreonam and cefotaxime were 82.2%,74.94%,69.92%,64.87%,59.95%,52.93%,49.88%,49.65%,44.50%,41.92%,38.17%,and 35.60%,respectively.CONCLUSIONS P.aeruginosa isolated from ICU of our hospital is suscepitable to imipenem,piperacillin/sulbactam,piperacillin,amikacin and the cephalosporins,but show lower susceptibility to other antibiotics.
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OBJECTIVE To understand the distribution and antibiotic resistance of E.coli isolated from our hospital and offer suggestions for clinic.METHODS The antibiotic susceptibility to 21 kinds of antibiotics were tested by K-B method and analyzed by Whonet software.RESULTS The antibiotic resistance of 301 E.coli strains to ampicillin,quinolones,piperacillin,gentamicin,cefazolin,cefuroxime,ceftriaxone,ceftazidime,aztreonam,cefepime, ampicillin/sulbactam were 83.39%,69.44%,62.79%,44.19%,42.86%,36.88%,35.22%,31.23%,29.90%,29.57% and 26.91%,respectively.CONCLUSIONS E.coli isolated from our hospital show high resistance to several kinds of antibiotics.The drugs should be choosed reasonably according to their antibiotic suscepitibity results.
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OBJECTIVE To explore risk factors and preventive measure of wound infection after operations in clean wounds.METHODS The related factors of wound infection were analyzed by using Logistic analysis in 6805 cases from Jun 2004 to Dec 2005.RESULTS Age,duration of operation and diabetes mellitus were the risk factors for wound infection,but the antibiotic application was unrelated to wound infection in clean wounds.CONCLUSIONS The risk factors for wound infection are age,duration of operation and diabetes mellitus.
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OBJECTIVE To achieve the best treatment effect by the effective management to control abusing the clinical antibacterial drug. METHODS The management organization and system on antibiotics reasonable application were established.It also formulated an standard to examine the reasonable antibiotics application.It construced the information system of the antibiotics reasonable application management,to carry on the real-time monitoring to the clinical antibiotics application situation. RESULTS The antibiotics utilization ratio was from original 78% lowered to 65% and the antibiotics use hastened more reasonably. CONCLUSIONS The standardized management of antibiotics use is realized and the medical quality is improved.