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Objective To investigate the effect of preoperative chlorhexidine bath for reducing the incidence of sur-gical site infection(SSI)in patients undergoing spinal surgery.Methods All patients who undergoing spinal surgery (with no implants)in the department of neurosurgery of a hospital between January 2013 and December 2014 were monitored,the selected patients were divided into control group (January-December of 2013,no intervention meas-ures were taken)and trial group(January-December of 2014,1 .8%-2.2% chlorhexidine bath for two nights before operation),incidence of SSI between two groups of patients before and after intervention was compared,interven-tions effect was evaluated.Results A total of 1 043 patients undergoing spinal surgery were enrolled,41 (3.93%) had SSI,incidence of SSI rates in control group and trial group were 6.47% and 2.34% respectively,the difference was statistically significant (P=0.001).According to the incidence of SSI in control group,actual infected patients in trial group were 27 less than the anticipated patients with infection.The average hospitalization expense in SSI group and non-SSI group were ￥33 641 .00 and ￥23 072.50 respectively,each patient could save ￥10 568.50 on average.Therefore,through the intervention measures,￥285 349.50 of hospitalization expense could be saved. Except ￥2 100 of trial material cost and ￥12 820 of manual labour cost,￥270 429.50 of social cost was ultimately saved.The mean length of hospital stay in control group and trial group were 10 (8-12)days and 9 (8-12)days respectively,rank test showed that the difference was not statistically significant (Z = - 0.68,P = 0.50 ). Conclusion Chlorhexidine bath intervention can not only reduce SSI rate,but also save the expense of hospitaliza-tion,whether it can shorten the length of hospital stay needs to be further studied.
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BACKGROUND:How to promote homing of scarce limbal stem cel s is the key to improving transplantation efficiency. And stromal cel-derived factor-1 plays an important role in the repair of retinal pigment epithelial cel s injury. OBJECTIVE:To observe changes of stromal cel-derived factor-1 levels in rat and mouse limbal stem cel deficiency models in order to confirm whether these changes wil induce peripheral blood stem cel s homing into the cornea. METHODS:Eye models of limbal stem cel deficiency were prepared in rats and mice by cutting method, then peripheral blood samples were continuously drawn to detect the mass concentration of stromal cel-derived factor-1 by enzyme-linked immunosorbent assay within 1 month after modeling. RESULTS AND CONCLUSION:In the rat peripheral blood, the mass concentration of stromal cel-derived factor-1 started to increase at 24 hours after modeling and firstly peaked at the 3rd day;then it tended to decrease and reached a second peak lower than the first one at the 25th day;subsequently, it returned to the normal level. In the meanwhile, the mass concentration of stromal cel-derived factor-1 in the mouse peripheral blood, increased at 12 hours after modeling, peaked at the 3rd day, subsequently decreased until another peak lower than the former one presented at the 20th day, and final y it returned to the normal level. In conclusion, the level of stromal cel-derived factor-1 in the peripheral blood is significantly associated with limbal stem cel s deficiency, which may play an important role in corneal injury repair.
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Objective To investigate the incidence of healthcare-associated infection (HAI)in patients in a respiratory in-tensive care unit (RICU)of a teaching hospital,and provide reference for HAI prevention and control.Methods All pa-tients admitted to this RICU from January to December 2014 were surveyed with prospective targeted monitoring method, surveyed data were analyzed statistically.Results A total of 561 patients were surveyed,43 patients developed 44 times HAI,HAI rate and HAI case rate were 7.66% and 7.84% respectively,incidence of HAI and adjusted incidence of HAI per 1 000 patient-days were 6.26‰ and 1.79‰ respectively.The main infection site was urinary tract (45.46%,n=20). Incidence of ventilator-associated pneumonia (VAP ),catheter-related bloodstream infection (CRBSI),and catheter-associat-ed urinary tract infection (CAUTI)per 1 000 catheter-days were 2.73‰(n=13),1.57‰(n=2),and 3.78‰(n=18)re-spectively.Incidence of HAI per 1 000 patient-days between the first and second half year of 2014 was significantly differ-ent(4.59‰ vs 7.89‰;u=-1.75,P =0.04).A total of 47 pathogenic strains were isolated,the main pathogens were gram-negative bacteria(n=26,55.32%).Conclusion The major HAI in RICU is device-associated infection,it is necessary to strengthen the management of invasive procedures;targeted monitoring can find the weak links of infection control prac-tice and helpful for taking effective prevention and control measures to reduce the incidence of HAI in ICU.
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Objective To explore strategies and measures to improve hand hygiene (HH)compliance and correctness of health care workers (HCWs)in a large hospital.Methods The WHO multimodal hand hygiene improvement strategy was adopted by healthcare-associated infection(HAI)management department of a hospital,measures consisted of five key com-ponents,including:system change,education and training,evaluation and feedback,reminders in the workplace,and insti-tutional safety climate.HH compliance and correctness of HCWs were observed by infection control practitioners,HH compliance and correctness in January-June of 2012 (pre-intervention)and January-June of 2014 (post-intervention)were compared,effectiveness of intervention strategies were evaluated.Results HH compliance rate and correctness rate of post-intervention were both higher than pre-intervention (75.92% [8 369/11 023]vs 53.67% [5 127/9 553],P 0.05).Except ‘after body fluid exposure’, HH compliance rates of the other four indications for HH before and after intervention were significantly different(all P <0.001).Conclusion HH compliance and correctness of HCWs can be improved after adopting WHO multimodal hand hy-giene improvement strategy.
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BACKGROUND:Stromal cel-derived factor-1 (SDF-1) and chemokine receptor-4 (CXCR4) play an important role in stem cel homing during bone marrow, organ and tissue transplantation. But there are few reports on limbal stem cel transplantation and homing as wel as the distribution and content of SDF-1/CXCR4 on the cornea. OBJECTIVE:To detect the expression levels of SDF-1/CXCR4 mRNA in rat corneal tissue by fluorescence quantitative PCR. METHODS: The normal rat cornea was taken completely, and subdivided into central cornea, peripheral corneal and limbal area. Fluorescence quantitative PCR method was employed to detect SDF-1/CXCR4 mRNA levels at corresponding positions. RESULTS AND CONCLUSION: The expression levels of SDF-1 and CXCR4 mRNA were 0.213±0.015 and 0.189±0.02 in the central cornea, 0.529±0.077 and 0.285±0.015 in the peripheral cornea, 0.666±0.069 and 0.258±0.067 in the limbal area, respectively. These data show that there are significant differences in the expression levels of SDF-1 and CXCR4 mRNA in the central cornea, peripheral corneal and limbal area, and these differences exert an important role in cel homing and migration during limbal stem cel transplantation for treatment of limbal stem cel deficiency.
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Objective To explore the risk factors and prognosis of hospitalized patients with bloodstream infection due to carbapenem-resistant Acinetobacter baumannii (CRAB).Methods 163 patients with CRAB bloodstream in-fection from 2010 to 2013 were conducted retrospective case-control study,68 patients with bloodstream infection due to carbapenem-susceptible Acinetobacter baumannii (CSAB)during the same period were as control group. Results The independent risk factors for CRAB bloodstream infection were stay in intensive care unit(ICU)(OR, 1 .27[95%CI ,5.55-22.89])and emergency department(OR,3.57 [95%CI ,1 .67 -7.62])before infection.Pa-tients with CRAB bloodstream infection had lower 28-day survival rate than those with CSAB bloodstream infection (66.17% vs 96.95%,χ2 =15.71 ,P <0.001 ).The independent risk factors for influencing prognosis of Acineto-bacter baumannii bloodstream infection were infection of CRAB (HR 95% CI ,3.01 -67.28),blood disease(HR 95%CI ,3.77-25.97),cardiac insufficiency(HR 95%CI ,2.10-20.41),stay in ICU(HR 95%CI ,1 .01 -5.28), and age(HR 95%CI ,1 .01 -1 .04).Conclusion The independent risk factors for CRAB bloodstream infection are stay in ICU and emergency department before infection,CRAB bloodstream infection is risk factor for influencing prognosis of patients.
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Objective To understand the impact of methicillin-resistant Staphylococcus aureus (MRSA)blood-stream infection on the length of hospital stay,hospital mortality,and poor prognosis of patients.Methods 357 patients with Staphylococcus aureus (S .aureus)bacteremia in a hospital between January 1 ,2009 and December 31 , 2013 were surveyed and analyzed retrospectively.Results Of 357 patients,91 were infected with MRSA and 266 with methicillin-susceptible S .aureus (MSSA).The length of hospital stay was statistically different between MR-SA and MSSA group(29 d vs 23 d,P <0.01);before infection,length of hospital stay of MRSA group was longer than MSSA group(P <0.01 );after infection,length of hospital stay was not statistically different between two groups(17 d vs 16.5 d,P = 0.92 ).Mortality of MRSA group and MSSA group was not statistically different (13.19% vs 9.02%,χ2 =1 .28,P =0.26).The incidence of poor prognosis of MRSA group was higher than MSSA group(29.67% vs 16.92%,χ2 =6.85,P =0.01 ).Multivariate analysis results showed that MRSA infection was independent risk factor for poor prognosis (P <0.01).Conclusion MRSA infection doesn’t contribute to the pro-longation of hospital stay,but MRSA bloodstream infection is a risk factor for poor prognosis of patients.
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<p><b>OBJECTIVE</b>To observe the effect of Jinmaitong capsule (JMT), a compound traditional Chinese medicine, on expressions of inducible nitric oxide synthase (iNOS) and nitro tyrosine (NT) protein in streptozocin-induced diabetic (STZ-DM) rats.</p><p><b>METHOD</b>Intraperitoneal injection of streptozocin in rats to establish a model. STZ-DM rats were randomly divided into the model control group (distilled water), the small-dose JMT group (JMT at dose of 0.45 g x kg(-1) x d(-1)), the medium-dose JMT group (JMT at dose of 0.88 g x kg(-1) x d(-1)), the large-dose JMT group (JMT at dose of 1.75 g x kg(-1) x d(-1)) and Vitamin C group (VC at dose of 0.05 g x kg(-1) x d(-1)). Ten normal rats with matching weight and age were selected as the normal control group (distilled water). After intragastric administration for 16 weeks, the expressions of iNOS and NT in sciatic nerve were detected by the immunohistochemistry method.</p><p><b>RESULT</b>The expression levels of iNOS and NT protein in diabetic rats were higher than those in normal rats (P<0.05, P<0.01). Compared with the model group, the levels of iNOS and NT protein in JMT and VC groups were significantly decreased (P<0.05, P<0.01). Particularly, the medium-dose JMT group showed a better effect than the VC group (P<0.05, P<0.01).</p><p><b>CONCLUSION</b>JMT could down-regulate the expressions of iNOS and NT protein of sciatic nerve in diabetic rats.</p>
Subject(s)
Animals , Male , Rats , Blood Glucose , Body Weight , Capsules , Diabetes Mellitus, Experimental , Drug Therapy , Metabolism , Pathology , Diabetic Neuropathies , Drug Therapy , Metabolism , Pathology , Drugs, Chinese Herbal , Pharmacology , Enzyme Activation , Nitric Oxide Synthase Type II , Metabolism , Rats, Sprague-Dawley , Sciatic Nerve , Metabolism , Pathology , Tyrosine , MetabolismABSTRACT
To investigate the effects of medicated serum prepared by administration of Jinmaitong (JMT), a compound Chinese herbal medicine, on nicotinamide adenine dinucleotide phosphate (NADPH) oxidase p22-phox subunit and inducible nitric oxide synthase (iNOS) of rat Schwann cells cultured in high-glucose medium.
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OBJECTIVE To raise the level of laboratory diagnosis of diarrheal pathogens.METHODS The stool samples were inoculated on the of SS agar,SMAC agar,TCBS agar,blood agar.RESULTS Over the past three years in our hospital pathogen detection rate of diarrhea was 48.2%.The scope of the baeteria isolated were not limited to Salmonella and Shigella,but also Escherichia coli-induced diarrhea,Vibrio,Staphylococcus arreus,Candida albicans.The Klebsiella,Proteus,Citrobacter,Pseudornonas aeruginosa and the like were also detected out.CONCLUSIONS It′s important to choose right medium and detect intestinal pathogens in clinical.
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OBJECTIVE To investigate the distribution and resistance of pathogens in lower-respiratory tract infection in our area,and help doctors to use antibiotic reasonably.METHODS According to National Guide to Clinical Laboratory Procedures,API identification system or K-B method,the pathogens of 1326 cases sputum specimens were isolated,identified and tested in drug sensitive test.RESULTS A total of 982 strains of pathogens that included 540(20.0%) G-bacilli,196(20.0%) G+ cocci and 246(25.1%) fungi were isolated from 1326 sputum specimens and the detection rate was 74.1%.From them 176 cases which occupied 13.3% were with mixed infection.The drug resistance of G-bacilli to imipenem was the lowest,then was to cefoperazone and amikacin,but the resistance of ampicillin was the highest.From 234 strains of Klebsiella had 89 strains of ESBLs-positive;in 50 strains of Escherichia coli,the strains of ESBLs-positive were 20(40.0%).The resistance rate of Staphylococcus aureus and S.epidermidis to penicillin was 97.5% and 97.2%,respectively,both of them were sensitive to vancomycin,and less sensitive to ciprofloxacin.Fifty seven strains of MRSA were detected from 90 strains of S.aureus(63.3%);and 42 strains of MRSE were detected(56.0%).CONCLUSIONS G-bacilli are the main pathogens in lower respiratory tract infection and the infection caused by fungi is more than that caused by G+ cocci,so we must pay attention also to mixed infection which occupies certain ratio.