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Objective:To study the safety of different peripherally inserted central catheter (PICC) dressing replacement frequencies in preterm infants.Method:From June 2017 to February 2020, preterm infants were enrolled in this prospective randomized controlled study. Preterm infants with PICC were randomly assigned into 7 d, 11 d and 14 d dressing replacement groups using online randomization software. Polyurethane transparent dressing and the same dressing replacement method were used in all three groups. The incidences of catheter-related bloodstream infection (CRBSI) and positive skin bacterial culture at dressing site were compared among the three groups.Result:A total of 296 cases were enrolled, including 96 cases in the 7 d group, 108 cases in the 11 d group and 92 cases in the 14 d group. The incidences of CRBSI in three groups were 2.5/1 000 catheter day in 7 d group, 1.1/1 000 catheter day in 11 d group and 0.8/1 000 catheter day in 14 d group. The incidences of catheter pathogen colonization were 1.0% in 7 d group, 0.9% in 11 d group and 0% in 14 d group. The positive rates of skin bacterial culture at dressing site were 1.0% in 7 d group, 2.8% in 11d group and 2.2% in 14 d group. The incidences of PICC exit site infection in three groups were 1.0% in 7 d group, 0.9% in 11d group and 1.1% in 14 d group and no significant differences existed among the groups ( P>0.05). Gram-positive cocci were the main bacteria [91.7% (11/12)] of CRBSI and skin bacterial culture at dressing site and gram negative bacilli accounted for 8.3% (1/12). No fungal infection were found. Conclusion:It is safe to replace the PICC dressing in premature infants as needed within 14 days if the dressing is intact without curling, bleeding and exudation.
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Objective To evaluate the effects on catheter related blood stream infection by different dressing frequency of peripherally inserted central catheter(PICC)with neonates. Methods A systematic review of randomized controlled trials (RCTs) from databases, Data were searched about the transparent dressing replacement frequency for neonatal PICC catheterization. The meta-analysis was performed by using RevMan 5.2 software. Results Nine RCTs were included in a total of 1 730 patients. Meta analysis showed that there was no significant difference in the incidence of PICC puncture dressing, catheter-related infections (including puncture port infection, catheter-related blood flow infection, catheter bacterial colonization) at every 3, 5, and 7 days (P> 0.05). Conclusion the dressing of PICC catheter are replaced will not increase the incidence of catheter-related infections within 7 days, throughout the more appropriate frequency of dressing replacement is once every 7 days.
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Objectives@#To establish SD rat model with type 2 diabetes mellitus (DM) and concomitant chronic periodontitis (CP) and to evaluate the influence of periodontitis on the vascular lesions of type 2 diabetes rats.@*Methods@#Totally 241 clean level SD rats were randomly divided into four groups, group A (normal control, NC, n=27), group B (DM, n=34), group C (CP, n=90) and group D (DM+CP, n=90). The rats of DM group were fed with high-fat and high-sugar diet for 8 to 10 weeks, and then were multiply injected with small dose streptozotocin under the condition of ice bath. Blood sugar levels after the injection were dynamically monitored at 72 h, 1 week, 2 weeks and 4 weeks, respectively. The CP model was established by means of ligation. Bilateral maxillary first and second molars were selected and ligated using 0.2 mm orthodontic wires binding with 4-0 surgical suture soaked with Porphyromonas gingivalis (Pg) suspension. After a period of 14 weeks, all the rats were put to death. Maxillary samples were subjected to methylene blue staining to observe alveolar bone loss. Bilateral carotid artery specimens were collected. The left carotid artery specimens were used to detect the prevalence of Pg using quantitative real-time PCR. The right carotid artery specimens were used to observe pathological changes.@*Results@#Blood sugar levels of rats in group B and D increased and changed sharply after Streptozotocin injection with in 1 week. Symptoms of 'more drink, more food and body weight loss’ appeared. The fasting blood glucose (FBG) was more than 7.8 mmol/L and (or) the random blood glucose (RBG) was more than 17.8 mmol/L. Both FBG and RBG became stable after 2 to 3 weeks. Levels of HbA1C in group B and D ([7.32±0.45]%, [9.41±0.45]%) were significantly higher than that of group A ([4.02±0.45]%) (P<0.01). Rats of group D were observed the most severe bone loss showing wider interdental space and furcation involvement. Pathological results of carotid artery tissues of group D showed the worst lesions including thinning and calcification of vessel walls, and breaking down or disappearance of elastic fibers. The prevalences of DNA of Pg in groups of A, B, C and D were 3/7, 3/7, 6/7 and 7/7, respectively. The bacteria numbers detected by quantitative real-time PCR in groups C and D were significantly higher than that of groups A and B (P<0.01).@*Conclusions@#Rat model of type 2 DM with periodontitis was successfully established in the present study. Carotid artery specimens from DM+CP model rats showed typical vascular lesions such as calcification and fiber disorders. Pg was found in all carotid specimens and the highest bacteria numbers were detected in the composite model rats. The Pg might play a role in the progress of diabetes vascular lesions.
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In order to strengthen the management of clinical teaching, improve the teaching quality of clinical practice, the advantages of the traditional medical education, teaching reform and medical simulation were further integrated, using PDCA (Plan-Do-Check-Action) cycle model in medi-cal college students' clinical practice training and evaluation. The skills of training and evaluation were optimized and practiced by thechain model of teaching-assistance-guidance to improve the train-ing quality of interns, and make continuous improvement from the angle of teaching, learning and management and with PDCA circulation mode. Practice shows that the application of PDCA circulation management has greatly improved teachers' teaching quality and their own quality, and the students' satisfaction of practice teaching management and clinical teachers has also significantly increased. The effect is obvious.
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22 cases of chronic gastritis,8 cases of gastric cancer,and 3 cases of other gastric diseases.10 hea'thy adults were also studied to serve as the control.According to the diagnostic criteria of Chinese traditional medicine ,58 cases with epigastric pains out of the 80 were categorized into the group of spleno-gastric asthenia (SGA) of 35 cases and the group of hepatogastric incoordinatin (HGI) of 23 cases.The basal pressure and rhythmic contractions of the stomach in response to a definite volume loading were recorded.It was found that 60% of SGA cases and 56.8% of PU cases showed only a few low-amplitude or no contractions in response to all varieties of volume loading,which were significantly higher than that in HGI cases (26%) and the control (10%).In the interval between the contractions and relaxations of the proximal stomach the intra-gasrric pressure was significantly lower in SGA and PU cases than in HGI cases and the control.These findings indicate that the tension and contractility of the mesculature of the proximal stomach are markedly reduced in patients with PU and SGA.