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" Internet plus" pharmacy service center of Sir Run Run Shaw hospital is the first in Zhejiang province to realize online revisits and medication dispensing covered by medical insurance. The entire process of pharmacy service, namely prescriptions, prescription-checking, payment, delivery, consulting, and continuing education can be completed only via the " Internet-plus" center. The practice can improve efficiency of the medical service of the hospital, minimize outpatients stay in the hospital and cross infections so incurred, functioning as an innovative pharmacy service mode against COVID-19 epidemic.
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Objective:To explore the patterns and causes of occupational exposure to infectious diseases (OEID) among frontline medical staffs (FMS) in coronavirus disease 2019 (COVID-19) isolation wards (CIW), and the particularity of post-OEID management and the measures to prevent OEID.Methods:A total of 1 061 FMS of Wuhan Huoshenshan Hospital from February 4 to March 21, 2020 were enrolled. The OEID of FMS was investigated and analyzed from the perspectives of FMS physical and psychological conditions, protective equipment, infection-control related regulations and procedures, local air quality, exposure patterns, and the particularity of emergency treatment after exposure.Results:The incidence of OEID among FMS was 2.0%(21/1 061). The nurses and doctors accounted for 95.2%(20/21) and 4.8%(1/21), respectively. The incidences in 17 general wards and two intensive care units (ICU) were 71.4%(15/21) and 28.6%(6/21), respectively. Nearly 90.5%(19/21) and 9.5%(2/21) of the OEID events occurred in contaminated area and potential contaminated area, respectively. About 23.8%(5/21) of the OEID events were air exposure of oral-nasal skin, mucosa and respiratory tract, which was secondary to uncontrollable vomiting, and 76.2%(16/21) were pricking injuries. The inducement factors involved poor quality and inappropriate wearing of some goggles, atomization of the inside of goggles leading to blurring vision, chest distress and decreased sense of touch and operational flexibility related to level-3 protection equipment, poor air quality, FMS physical and psychological conditions, etc. Under the direction of "the Procedures for Handling OEID" , all incidents are properly handled and no FMS was infected by 2019 novel coronavirus and blood-borne pathogens. No new OEID event was found after the strict implement of set of preventive measures.Conclusions:The OEID among FMS in CIW is attributed to multiple causes. The optimized process that takes into account the specificity of OEID management for both COVID-19 and blood-borne infectious diseases can effectively prevent potential post-exposure infections. And reasonable precautions can fully reduce the risk of OEID of FMS in CIW.
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Objective: To develop an HPLC-DAD method for the simultaneous determination of five active constituents (chlorogen-ic acid, baicalin, rutin, linarin and apigenin) in Cirsii Herba dispensing granules. Methods: The chromatographic separation was per-formed on a Thermo Hypersil BDS C18column (250 mm×4. 6 mm,5 μm) with gradient elution by 0. 1% phosphoric acid-acetonitrile as the mobile phase at the flow rate of 1. 0 ml·min-1. The detection wavelength was set at 326 nm,and the column temperature was maintained at 35 ℃. Results: Chlorogenic acid, baicalin, rutin, linarin and apigenin were linear within the range of 0. 072-1. 446 μg (r=0.999 7), 0.043-0.864 μg(r =0.999 5), 0.094 2-1.884 μg (r =0.999 7), 0.150-3.000 μg (r =0.999 8) and 0.043-0. 856 μg (r=0. 999 6), respectively. The recovery was 97. 67% , 98. 19% , 97. 92% ,98. 12% and 98. 02% , and the RSDs was 0. 82% , 0. 92% , 1. 25% , 0. 98% and 1. 17% , respectively. Conclusion: The method is accurate, convenient and reproducible in the quality control of multicomponents in Cirsii Herba dispensing granules.
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According to the infection characteristics of batches of patients with extensive burns in dust explosion, the article focused on the concept and mode of whole-range fine management.Based on the characteristics and rules of infection prevention in bat-ches of patients with extensive burns, the measurement and examination of infection management were refined, the infection monitoring indexes were designed scientifically, the infection prevention scheme and monitoring table were formulated.By early and whole-range intervention of infection prevention, quantitative evaluation, fine management and precise control at different times, all levels of infec-tion management teams could fully serve their purposes in order to realize effective infection prevention.
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Objective To investigate the occurrence of central venous catheter-related bloodstream infection(CRB-SI)in mass severe burn patients,evaluate related risk factors for infection,and effectiveness of prevention and con-trol measures.Methods In August 2014,9 cases of severe burn patients were rescued in a hospital,all patients re-ceived CVC,infection prevention and control intervention measures were performed during the whole process of catheterization.Results All patients received 30 episodes of CVC,total CVC-days were 227 days,bacterial culture for three-cavity catheters of femoral veins in 2 patients were positive,incidence of CRBSI was 8.81 ‰;1 patient was isolated Enterococcus faecium ,1 isolated both Acinetobacter baumannii and Stenotrophomonas maltophilia .2 CRB-SI patients received femoral vein catheterization,catheterization site was trauma surface,duration of catheterization were both ≥7 days,both used three-cavity catheters,and third degree burns were ≥60%,both patients were cured after timely removal of catheters and receiving of antimicrobial agents.Conclusion CVC is helpful for long term, safe and effective fluid infusion,but it can cause CRBSI;infection prevention and control intervention for patients receiving CVC during the whole process of catheterization can reduce the occurrence of CRBSI.
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Objective To explore the change trend and antimicrobial resistance of pathogens causing infection in extensive burn patients,and provide reference for clinical prevention and treatment.Methods Specimens from 9 extensive burn patients who were admitted to a hospital at the same time were performed pathogenic culture and an-timicrobial susceptibility testing, change trend and antimicrobial susceptibility of pathogens were observed. Results The main specimen was wound secretion,accounting for 93.81 %.The major pathogens causing infection were Acinetobacter baumannii (44.85%),Staphylococcus aureus (32.47%),Pseudomonas aeruginosa (12.37%), and Klebsiella pneumoniae (5.15%).With the prolongation of hospital stay,pathogens changed from one kind to multiple strains, and from susceptibility to resistance,multidrug resistance,and extensive drug resistance. Conclusion Itis difficult to avoid infection in burn patients,timely realizing the changes of pathogens causing infec-tion and antimicrobial resistance play an important role in the control of infection.
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This paper summarizes the systematic management of artificial airway for 36 postoperative patients with laryngeal cancers. A full-time nurse is responsible for the systematic artificial airway management to implement respiratory care,endotracheal tube care,infection prevention and control,nutritional support and health education. As a result,the incidence of fever,frequent cough,and bloody sputum was 2.12%. Pharyngeal fistula and pulmonary infection occurred in one patient,respectively. All the patients recovered well after intensive care. It is suggested that systematic artificial airway management can effectively reduce complications,improve the quality of nursing and increase patient satisfaction.
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Objective To elucidate the effects of endothelin-1(ET-1) on expression of extra-regulated kinase 1(ERK 1), cell cycle and changes of Ca 2+ in activated hepatic stellate cells (HSCs). Methods Effects of different concentra tions of ET-1 on ERK 1 expression were determined by Western blotting. Effects of ET- 1 on cell cycle were observed by flow cytometry(FCM) analysis. Effects of ET-1 on changes of calcium concentration and cell area were observed by laser scanning confocal microscopy (LSCM). Results ET-1 could inhibit the expression of ERK 1 i n a dose-dependent manner, compared with the control, the expression of ERK 1 in E T-1 highest concentration group decreased 10.91%?3.36% (P