Adjuvant Therapy of Sepsis-associated Thrombocytopenia with Intravenous Immunoglobulin / 实用医学杂志

Objective To investigate the adjuvant effect of intravenous immunoglobulin on patients with sepsis-associated thrombocytopenia. Methods A total of 229 patients with sepsis with platelet count less than 3 × 109/L, were included in this prospective, randomized, controlled study. The patients were divided into the intervening group and the control group. Conventional treatments were applied in the two both groups , while in the intervening group, intravenous immunoglobulin with a dose of 0.4 g/(kg·d) for 5 consecutive days was administered. The end-points were the platelet counts on day 1,day 3,day 5,and day 7 post-intravenous immunoglobulin, patients’ in-ICU time and the 28-day in-hospital mortality. Results Compared with the control group, the platelet count recovered dramatically after 5-day intravenous immunoglobulin in the intervening group. Moreover , the 28-day in-hospital mortality and in-ICU time were also dramatically improved in the intervening group. Conclusion Intravenous immunoglobulin can enhance the recovery of platelet counts , shorten the in-ICU time and reduce the hospital mortality in patients with sepsis- associated thrombocytopenia (PLT count < 30 × 109/L).

Clinical investigation of continuous venous-venous hemofiltration and continuous venous-venous hemodialysis on lactic acidosis / 中华急诊医学杂志

Objective To investigate the effect of continuous venous-venous hemofiltration (CVVH) and continuous venous-venous hemodialysis (CVVHD) on patients with lactic acidosis.Methods A total of 137 cases with lactic acidosis were included in this prospective randomized control study.lhe patients were collected from the University of Hong Kong-shenzhen Hospitall and the First Affiliated Hospital of Shantou University Medical College from April 2009 to April 2013.Inclusion criteria were patients with lactic acidosis.Exclusion criteria were patients with end-stage malignancy or terminal stage of illnesses.The patients were randomly divided into two groups:CVVH group and CVVHD group,and patients of both group were intervened with conventional treatments as well.For each group,the lactic acid and blood gas analysis were tested before CRRT,and at 4 hours,8 hours,12 hours,24 hours,and 48 hours of CRRT.The patients' mortality and length of ICU stay time were analysed and recorded.Statistical analysis was performed using SPSS 15.0software.Results When the length of time for treatment was the same,the efficacy between CVVH group and CVVHD group showed no difference in blood lactic acid level [4 h:(11.65 ± 3.39) mmol/L vs.(11.12±2.65) mmol/L; 8 h:(8.78±2.35) mmol/L vs.(8.59±2.09) mmol/L; 12 h:(6.91 ±1.67)mmol/Lvs.(6.74±1.76) mmol/L;24h:(1.66±0.39) mmol/Lvs.(1.51±0.30) mmol/L; 48 h:(0.95 ±0.24) mmol/L vs.(0.66 ±0.20) mmol/L,P ＞ 0.05) and pH value [4 h:(6.93 ±0.14) vs.(7.05±0.09);8h:(7.04±0.10)vs.(7.12±0.05); 12h:(7.13±0.07)vs.(7.20±0.04);24h:(7.30±0.03) vs.(7.38±0.04); 48h:(7.41 ±0.03) vs.(7.46±0.02),P＞ 0.05].There are also no difference in the hospital mortality (11.4％ vs.10.4％,P=0.854) and length ofICU stay time [(9.5 ±2.4) d vs.(8.8 ± 2.9) d,P =0.329].Conclusions Both CVVH and CVVHD can effectively correct hyperlactemia,enhance acid-base balance,contributing no differences in length of ICU stay time and patients' hospital mortality.

Practice and outcome of training models for chief doctors and nurses from primary hospitals in Henan province / 中华全科医师杂志

To advance the medical service system and strengthen the medical staff construction at primary hospitals,our hospital pioneered the training class for doctors and nurses from primary hospitals in Henan province in 2011.We offered the training fee and set rewards for them.The training classes included pre-job training,demonstration lessons,lectures,simulation training,discussion of intractable cases and clinical instructor training.The systematic training based on Henan provincial conditions plays a radiation role of big public hospitals and helps implement the grading medical services.

Investigation report on the current status of health resources in second-tier urban hospitals and above in Henan Province / 中华医院管理杂志

Objective To find out the possession and utilization of urban medical resources in Henan as well as other factors like medical quality, service level and human resources. Methods A general investigation was made of the possession and structure of health resources and the level of medical services in second tier urban hospitals and above in 18 cities of Henan Province. Results There are altogether 182 second tier urban hospitals in the province, with a total of 51 107 beds and a total of 22 859 doctors. The ratio of doctors to nurses is 1∶1 04, the bed utilization rate is 65 55%, the bed workdays are 234 63 days, the average bed turnover frequency is 15 51 times, and the average length of stay is 13 87 days. The average income surplus per hospital is 1 502 700 yuan, with the income from the sale of pharmaceuticals accounting for 44 67% of the total income. Conclusion The operating efficiency of second tier urban hospitals and above in Henan Province is close to the average national level, the structure of hospital allocations needs readjustment, and the percentage of income from the sale of pharmaceuticals is on the high side.