ABSTRACT
Objective To investigate the utility of plasma procalcitonin (PCT) as an early predictor for postoperative complications in patients who underwent elective pancreaticoduodenectomy (PD).Methods Clinical data of 87 patients who underwent elective PD in Changhai Hospital from March.1, 2016 to Dec.31, 2016 were collected.The general data, postoperative recovery, serum PCT level and white blood cell (WBC) count before, 1 d, 3 d and 5 d after PD were recorded.ROC curve was drawn and AUC was calculated to determine the cutoff value, sensitivity and specificity.Patients were divided into complication group (n=42) and noncomplication group (n=45) based on the occurrence of post-operative complications, and the comparisons between the two groups were performed.Results There were no significant differences on the age, gender, diabetes, obstructive jaundice, laboratory tests including PCT, operative time, blood loss volume during surgery and tumor type between the two groups, which were comparable.Complication group had longer hospitalization than noncomplication group (24 d vs 15 d,P0.05), but the plasma PCT level in patients with pancreatic fistula and peritoneal infection on 3 d and 5 d after PD was significantly higher than those in noncomplication group, and the difference was statistically significant (all P<0.05).The combination of plasma PCT and WBC on 3 d and 5 d after PD was superior to PCT or WBC alone in predicting pancreatic fistula (sensitivity 88.9%, 72.7%;specificity 68.5%, 78.2%) and abdominal infection (sensitivity 100%, 100%;specificity 45.9%, 44.4%).Conclusions Plasma PCT could predict the occurrence of abdominal infection and pancreatic fistula after PD.The combination of PCT and WBC might be more valuable in predicting abdominal infection and pancreatic fistula.
ABSTRACT
Objective To identify and investigate the cause of the unacceptable bacteria level inside the lumen of fiberendoscope during monitoring so as to increase the pass rate of its cleaning and disinfection. Methods A failure mode effect analysis of the cause was done and the workflow was thereafter improved. Meanwhile, pre and post bacteriological monitor was applied to the fiberendoscope lumen samples. Results The number of scrubbing times while manual cleaning affected the monitoring results. The scrubbing times was amended and the pass rate increased from 84.15% to 98.65%. The results were significantly different The failure mode risk index of endoscope cleaning and disinfection was calculated, and the highest two items were: The number of scrubbing times the operators execute RPN=640, the method of lumen cleaning RPN=480. These were the key factors of qualification of monitoring. Conclusions After the amendment, no less than 5 times' scrubbing was required and the bacteriological monitoring method was used to analyze the effects,thereafter the pass rate of lumen bacteria monitoring can be increased significantly.
ABSTRACT
Objective In order to discuss the evaluation of generalized sterization for dental handpieces. Methods The generalized sterization for dental handpieces were used inclued collection dental handpieces, automatically cleaned, dried and distilled with oil, packed with paper or plastics and sterized with pulse-vuccum. Results All the indexes were fitted to the standard after the generalized sterization among the dental handpieces. The valid rate was 100%. Conclusions Generalized sterization for dental handpieces are effective measures to guarantee the clinical sterization quality.