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Ventilator related events is a new concept proposed by the America Center for Disease Control and Prevention of the United States. Compared with ventilator-associated pneumonia, ventilator related events has objectivity in diagnosis. In 2013, the National Health Safety Network replaced ventilator-associated pneumonia monitoring in adult inpatients with ventilator-associated event monitoring. This review mainly introduces the concept of ventilator-related events, the evaluation of the relationship between ventilator-related events and respiratory pneumonia, the monitoring situation at home and abroad, and the related factors of ventilator-related events, so as to lay a foundation for the further study in the future.
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The management of healthcare services for the suspected cases in non-designated hospitalsis a serious concern in controlling coronavirus disease 2019 (COVID-19) epidemic. Owing to the complexity of care providers, large requirement of medical supplies as well as the possible needs off frequent transfers, the major difficulty is preventing the coronavirus from spreading while caring the suspected critical cases before the 2019 novel coronavirus ribonucleic acid test results are reported. For the purpose of enhancing the prevention of the propagation of COVID-19, this article puts emphasis on the following aspects in non-designated hospital Peking University Third Hospital: preparatory procedures of receiving critical suspected patients, the management of medical personnel during the waiting session of RNA test results, the delivering procedures of testing samples, the management of referred medical wastes, daily operations including the cleaning and sanitizing of caring units and the management of related patients after the testing session.
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Objective To establish criteria for determination of sputum retention in elderly patients with non-ar-tificial airway. Methods Interview and Delphi methods were used to preliminarily determine clinical indication of sputum retentionand its classification through two-round expert consultation among 25 experts. Final criteria for de-termination of sputum retention were determined through experts group discussion. Results During the two rounds of consultation,all the questionnaires were collected,the experts' authority coefficients were 0.936 and 0.926 respec-tively,and the coordination coefficient of expert opinion was statistically significant.Criteria for determination of spu-tum retention included ineffective cough plus auscultation phlegm sound,with or without complaining of sputum,de-creased blood oxygen saturation,difficulty breathing and cyanosis. Conclusion Based on expert consultation and ar-gument,the criteria for determination of sputum retention can facilitate clinical nurses to detect sputum retention.
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OBJECTIVE:To provide reference for suitable selection of antibacterial ophthalmic preparation in the clinic. METHODS:The application of antibacterial ophthalmic preparation in a hospital during Jan. 2013-Dec. 2016 were summarized and analyzed to calculate DDDs. The results of bacterial culture and identification,drug sensitivity test were collected. The correlation of DDDs of antibacterial ophthalmic preparation with resistance rates of bacteria was analyzed by using Pearson test. RESULTS:During 2013-2016,there were 7 categories of antibacterial ophthalmic preparations used in this hospital,involving 10 types. To-tal DDDs showed an upward trend with average annual growth rate of 26.16％. DDDs of Tobramycin (dexamethasone) eye drops were the highest for consecutive 3 years (2013-2015). Gatifloxacin eye drops/eye gel and Ofloxacin eye drops/eye oint-ment ranged 2nd-4th place in the list of DDDs. A total of 26143 ocular specimens were examined,and 21 kinds of bacteria were detected,involving 6221 strains with detection rate of 23.80％. Top 3 bacteria in the list of detection rate were Staphylo-coccus epidermidis (3067 strains),Streptococcus pneumoniae (470 strains) and Staphylococcus aureus (321 strains). Resistance rates of above 3 kinds of bacteria to erythromycin were all higher than 70％,while they were sensitive to rifampicin,chlorampheni-col,gentamicin and levofloxacin,etc. Compared to previous year,the average resistance rates of rifampicin(in 2015),gentamicin (in 2015,2016),tetracycline(in 2015),ofloxacin(in 2014,2015),levofloxacin(in 2016)and gatifloxacin(in 2016)had statisti-cally significant differences(P0.05). CONCLUSIONS:The main ocular infec-tions were S. epidermidis,S. pneumoniae and S. aureus. DDDs of tetracycline is certainly associated with resistant rates. Regulating clinical use of antibacterial ophthalmic preparation is important for delaying the development of bacterial resistance.
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Objective:To investigate the curative effect and safety of slow continuous ultrafiltration(SCUF) treatment on congestive refractory heart failure with renal failure, and to investigate the correlation between fluid balance and the postoperative complications.Methods:Thirty patients with congestive refractory heart failure with renal failure were chosen to receive slow continuous ultrafiltration treatment after deep vein catheterization, blood flow volume being 100-150 ml/min and therapy time being 24h. PiCCO was used to monitor the hemodynamic parameters, along with the change of blood pressure, blood oxygen saturation, heart beat and electrolyte.Results: After the slow continuous ultrafiltration treatment, the hemodynamic parameters of all patients showed obvious improvements, with better results on cardiac function and electrolyte balance. All the patients patients developed cardiopulmonary complications postoperatively have a larger total fluid balance of the first two days postoperatively than those without complications.Conclusion:SCUF have therapeutic effect and safety for treating congestive refractory heart failure with renal failure, and the status of the fluid balance can be a predictor of the postoperative morbidity and mortality.
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Objective: To investigate the optimal therapy for ICU post-cardiac arrest syndrome (PCAS) clinical efficacy in patients with cerebral resuscitation. Methods: In our hospital intensive care unit (ICU) treatment of cardiac arrest and the successful recovery of the 92 patients ,using randomly divided into control group and observation group of 46 cases, in which the control group taking conventional treatment hospital ICU, observation group hospital ICU optimize treatment , two groups of patients in the ICU treatment period nerve function, complications and mortality rates were analyzed. Results:The patients in the ICU and duration of mechanical ventilation was no significant difference, but a good neurological outcomes observed group of patients , 45.7%, significantly better than the control group, 21.7% , and the mortality rate was 45.7%, 73.9%, significantly lower than the control group , the difference was statistically significant (x2=3.84, P<0.05);complications compared in the two groups showed no significant difference. Conclusion: ICU optimize treatment can significantly improve cardiac arrest syndrome nerve function , and can effectively reduce mortality , worthy of further application.
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Objective To explore the condition of MYC/BCL2 protein coexpression in 245 patients with diffuse large B-cell lymphoma (DLBCL)and to find the correlations among MYC/BCL2 protein coexpres-sion,the germinal center B-cell-like (GCB)subtype and non-GCB subtype.Methods Paraffin-embedded lymphoma samples from 245 patients with DLBCL were studied using immunohistochemistry for MYC,BCL2, CD10,BCL6,MUM1 and KI67.And the protein expressions of them were analyzed.Results In the speci-mens of 245 patients with DLBCL,the patients with non-GCB were 163 (66.5%),and the patients with GCB were 82 (33.5%).The group of MYC/BCL2 protein coexpression comprised 35.9% (88/246)of the all patients.Non-GCB subtype group had a significantly higher frequency of MYC/BCL2 protein coexpression than the GCB subtype group (41.7%∶24.4%;χ2 =7.116,P=0.008).Conclusion The data shows that MYC/BCL2 protein coexpression occurs significantly more commonly in the non-GCB subtype.We can predict prog-nosis and choose therapeutic regimen base on the assessment for MYC and BCL2 protein expression.
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Purpose To investigate the clinicopathological features of multilocular cystic renal cell carcinoma ( MCRCC) , and to im-prove the understanding of this disease. Methods Thirty-two of MCRCC were studied by clinic data, pathological features and immu-nophenotype. All the thirty-two cases were followed up. Results In this study, thirty-two patients were diagnosed as MCRCC with a male-to-female ratio of 2.2 : 1, thirteen of whom had the tumor in the left kidney, eighteen in the right kidney, another in the double kidneys. The mean of tumor diameter was 4.6 cm (1.0~8.0 cm). Eleven patients underwent radical nephrectomy while the other 21 patients received nephron sparing surgery. Microscopically, all the cases were multiocular, lined in the cyst wall by a single layer of tumor cells with the clear or pale cytoplasm and Fuhrman grade 1 nuclei. Occasionally, the lining consisted of several layers of tumor cells or a few small papillae were present. The linings of the cyst wall were rich in thin-wall blood vessels. Immunohistochemically, the tumor cells were positive for CK(32/32), CK7(25/32), EMA(32/32), CD10(23/32) and vimentin(20/32), while negative for CD68. Conclusions MCRCC is characteristic by low grade nuclei, lacking solid nodules, and in the cyst wall, and has a favourable prognosis. The rich in thin-wall blood vessels and the lining cells with the clear or pale cytoplasm are diagnosis clues.
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<p><b>OBJECTIVE</b>To establish the seed quality grading standard of artificial tuber of Pinellia ternata.</p><p><b>METHOD</b>Hundred-grain weight, moisture content, germination rate, viability, single-grain diameter, purity and visual form of mature artificial tuber seed from tissue culture of P. ternate were determined. The key indicator and reference indicators for artificial tubers quality grading were defined statistically by SPSS analysis.</p><p><b>RESULT</b>Germination rate and viability were the primary indicators, hundred-grain weight, moisture content and purity were important reference indicators.</p><p><b>CONCLUSION</b>The quality of each grade should reach the following requirements: for first grade, hundred-grain weight > 10 g, moisture content > 70%-80% , germination rate > 80%, viability > 85%, single-grain diameter > 0.7 cm, purity > 80%; for second grade, hundred-grain weight 8-10 g, moisture content > 70%-80%, germination rate 60%-80%, viability 70%-85%, single-grain diameter 0.3-0.7 cm, purity 75%-80%; moisture content > 70%-80%, and the others don't reach second grade was the third grade.</p>