ABSTRACT
Objective To explore the effect of risk assessment method on the incidence of healthcare-associated infection (HAI) in high-risk departments.Methods A hospital was selected as the research object, risk assessment of HAI management at the hospital and department level was carried out, high-risk departments and high-risk links were screened out, targeted intervention was performed. Patients hospitalized in April-June 2017 were as control group and those hospitalized in July-September 2017 were as intervention group, incidence of HAI between two groups was compared.Results Through risk assessment at the hospital level, department of critical care medicine was the department with the highest risk, risk assessment at the department level showed that without wearing isolation clothes when contacting isolated patients during diagnosis and treatment, without using sterile sheeting when catheterization, and low correct rate of hand hygiene were high-risk links in department of critical care medicine. Targeted intervention was performed, isolation clothing allocation rate for contacting isolated patients increased from 0 to 100％, compliance rate to wearing isolation clothing among medical staff increased from 0 to 97.62％, implementation rate of using sterile sheet for deep vein catheterization increased from 72.50％ to 100％; hand hygiene correct rate increased from 85.00％ to 96.59％. Incidence of HAI decreased from 5.90％ to 2.64％, difference was statistically significant (P＜0.05).Conclusion Implementing risk assessment management of HAI in medical institutions can effectively guide the prevention and control of HAI in high-risk departments, and improve the level of HAI management.
ABSTRACT
To evaluate the neuroprotective effect of nerve growth factor ( NGF ) on acute angle-closure glaucoma patients after trabeculetomy.METHODS: Patients with viral keratitis who underwent trabeculectomy in treatment of acute angle - closure glaucoma in Xiamen Eye Center of Xiamen University from December 2011 to October 2013 were selected and completed the treatment, 61 eyes of 45 cases were followed up. The treatment group of 23 cases (32 eyes) with acute angle-closure glaucoma patients were treated by NGF gel for 3mo after trabeculetomy, while in the control group 22 cases (29 eyes) were treated by normal saline replaced NGF. All patients were followed up for at least 12mo, visual acuity, perimetry, retinal nerve fiber layer ( RNFL) thickness and cup/disc ratio of the patients were followed up during the treatment. The safety of topical use of NGF gel was also evaluated.RESULTS:ln all patients, the intraocular pressure ( lOP) was successfully controlled under 21mmHg and the visual acuity was markedly increased in the affected eye after trabeculectomy. Compared with control group, the postoperative lOP and visual acuity had no significant differences in treatment group (P>0. 05). The average light sensitivity of perimetry and mean defect were better than that in control group postoperative 6 and 12mo; The results of optical coherent tomography ( OCT ) and Heiderburg Retina Tomography ( HRT )-Ⅲ showed that RNFL thickness was significantly greater than that in control group, while cup/disc ratio significantly less than that in control group postoperative 6 and 12mo. Ocular surface damage, corneal endothelium to reduce and other eye complication were no observed in treatment group.CONCLUSlON:Acute angle-closure glaucoma treated by NGF gel after operation is effective and safe.
ABSTRACT
<p><b>BACKGROUND</b>Cyclic adenosine monophosphate (cAMP) could activate chloride channels in bovine ciliary body and trigger an increase in the ionic current (short-circuit current, Isc) across the ciliary processes in pigs. The purpose of this study was to investigate how cAMP modulates Isc in isolated human ciliary processes and the possible involvement of chloride transport across the tissue in cAMP-induced Isc change.</p><p><b>METHODS</b>In an Ussing-type chamber system, the Isc changes induced by the cAMP analogue 8-bromo-cAMP and an adenylyl cyclase activator forskolin in isolated human ciliary processes were assessed. The involvement of Cl(-) component in the bath solution was investigated. The effect of Cl(-) channel (10 µmol/L niflumic acid and 1 mmol/L 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS)), K(+) channel (10 mmol/L tetraethylammonium chloride (TEA)), or Na(+) channel blockers (1 mmol/L amiloride) on 8-bromo-cAMP-induced Isc change was also studied.</p><p><b>RESULTS</b>Dose-dependently, 8-bromo-cAMP (10 nmol/L-30 µmol/L) or forskolin (10 nmol/L-3 µmol/L) increased Isc across the ciliary processes with an increase in negative potential difference on the non-pigmented epithelium (NPE) side of the tissue. Isc increase induced by 8-bromo-cAMP was more pronounced when the drug was applied on the NPE side than on the pigmented epithelium side. When the tissue was bathed in low Cl(-) solutions, the Isc increase was significantly inhibited. Finally, niflumic acid and DIDS, but not TEA or amiloride, significantly prevented the Isc increase induced by 8-bromo-cAMP.</p><p><b>CONCLUSIONS</b>cAMP stimulates stroma-to-aqueous anionic transport in isolated human ciliary processes. Chloride is likely to be among the ions, the transportation of which across the tissue is triggered by cAMP, suggesting the potential role of cAMP in the process of aqueous humor formation in human eyes.</p>